Kumar L, Singh S
Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Indian J Pediatr. 1996 May-Jun;63(3):323-34. doi: 10.1007/BF02751524.
Vasculitis in children is uncommon and hardly any information is available from India. We, at PGIMER, Chandigarh, have diagnosed and followed many children with vasculitis of different types though not all, which occur in children. In this article, we have given an overview of the vasculitides that we have encountered along-with a review of relevant literature. We have described 8 children with classical PAN and have highlighted a higher frequency of CNS involvement in our patients. Amongst the 10 BCPAN children, as many as 8 had peripheral gangrene which resulted in auto-amputation in 7. Gangrene of such severity has not been previously reported in this condition. We have also included 30 children with HSP. Gastrointestinal involvement was noted in 86.7% of children and in one of these, it was severe enough to result in hypovolemic shock. Such severe bleeding is very rare. Two of our patients with HSP came late to us after having been operated for an 'acute abdomen' elsewhere. Although renal involvement was seen less frequently than reported in the literature, the severity of involvement was greater (nephrotic range proteinuria in 62% and azotemia in 50%). We have only limited experience of Kawasaki Disease but it appears that children with this disorder are probably not being diagnosed in the acute stage in our country.
儿童血管炎并不常见,印度几乎没有相关信息。我们在昌迪加尔的PGIMER诊断并跟踪了许多不同类型的儿童血管炎患者(尽管并非全部)。在本文中,我们概述了我们遇到的血管炎,并对相关文献进行了综述。我们描述了8例典型结节性多动脉炎患儿,并强调了我们的患者中中枢神经系统受累的频率较高。在10例皮肤型结节性多动脉炎患儿中,多达8例出现外周坏疽,其中7例导致自截。此前尚未报道过这种严重程度的坏疽。我们还纳入了30例过敏性紫癜患儿。86.7%的患儿出现胃肠道受累,其中1例严重到导致低血容量性休克。这种严重出血非常罕见。我们的2例过敏性紫癜患者在其他地方因“急腹症”接受手术后才来找我们。虽然肾脏受累的频率低于文献报道,但受累的严重程度更高(62%出现肾病范围蛋白尿,50%出现氮质血症)。我们对川崎病的经验有限,但在我国,这种疾病的患儿似乎在急性期未得到诊断。