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[过敏性紫癜的回盲部表现作为罕见的克罗恩病鉴别诊断]

[Ileocecal manifestation of Schoenlein-Henoch purpura as a rare differential Crohn disease diagnosis].

作者信息

Harsch I A, Wiest G H, Hahn E G, Nusko G

机构信息

Medizinische Klinik I mit Poliklinik der Friedrich-Alexander-Universität, Erlangen.

出版信息

Z Gastroenterol. 2000 Nov;38(11):905-8. doi: 10.1055/s-2000-10295.

Abstract

In the case of a 21-year-old patient gastroscopy and coloscopy were performed because of recurrent abdominal pain with diarrhea and vomiting. Colonoscopy showed moderate signs of inflammation of the rectum and aphthoid ulcerations in the terminal ileum. Since the macroscopic and clinical presentation was compatible with Crohn's disease, therapy with sulfasalacine was started. Because histology showed only lymphoid hyperplasia and the patient was asymptomatic at that time, the medication was ceased. Recurrence of abdominal pain and weight loss, proteinuria and a recurrent palpable purpura of the shanks in synopsis with the result of the previous colonoscopy led to a suspected diagnosis of Schoenlein-Henoch purpura with cutaneous, renal and abdominal manifestation which was confirmed by dermal and renal biopsies.

摘要

对于一名21岁的患者,因反复出现腹痛、腹泻和呕吐而进行了胃镜和结肠镜检查。结肠镜检查显示直肠有中度炎症迹象,回肠末端有口疮样溃疡。由于宏观表现和临床表现与克罗恩病相符,遂开始使用柳氮磺胺吡啶进行治疗。因为组织学检查仅显示淋巴组织增生,且患者当时无症状,所以停止了用药。腹痛复发、体重减轻、蛋白尿以及与之前结肠镜检查结果相关的小腿反复出现可触及的紫癜,导致怀疑诊断为具有皮肤、肾脏和腹部表现的过敏性紫癜,皮肤和肾脏活检证实了这一诊断。

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