Shinohara M, Ideura H, Yano S, Maezawa A, Nojima Y, Naruse T
Department of Internal Medicine, Maebashi Red Cross Hospital, Gunma.
Ryumachi. 2000 Aug;40(4):699-704.
A 19-year-old woman had been treated for bronchiectasis since she was born. In October 1995, she was diagnosed as Henoch-Schönlein purpura (HSP) and HSP nephritis with the findings as follows; palpable petechial rash of legs, abdominal pain, arthralgias, and proteinuria. The administration of oral prednisolone was started, the clinical symptoms except for proteinuria was disappeared. However, nephrotic syndrome was continued despite the therapy of intravenous methylprednisolone pulse, various immunosuppressive drugs and warfarin. In February 1998, she was admitted to our hospital because of pneumonia. Several days later, her pneumonia improved on treatment with antibiotics, but she suddenly developed transient cortical blindness and acute renal failure. A provisional diagnosis of hypertensive encephalopathy and cerebral edema related to vasculitis was made, and she was treated with nifedipine, Glycelo, and high dose immunoglobulin. After the treatment, her vision and renal function had improved. She is a rare case associated with transient cortical blindness, bronchiectasis, and HSP.
一名19岁女性自出生起就因支气管扩张接受治疗。1995年10月，她被诊断为过敏性紫癜（HSP）及HSP肾炎，表现为腿部可触及的瘀点皮疹、腹痛、关节痛和蛋白尿。开始口服泼尼松龙治疗后，除蛋白尿外的临床症状消失。然而，尽管接受了静脉注射甲泼尼龙冲击治疗、多种免疫抑制药物及华法林治疗，肾病综合征仍持续存在。1998年2月，她因肺炎入院。几天后，抗生素治疗使她的肺炎有所改善，但她突然出现短暂性皮质盲和急性肾衰竭。初步诊断为与血管炎相关的高血压脑病和脑水肿，给予硝苯地平、甘油及大剂量免疫球蛋白治疗。治疗后，她的视力和肾功能有所改善。她是一例罕见的合并短暂性皮质盲、支气管扩张和HSP的病例。
