儿童过敏性紫癜回顾性分析：诊断难点与肾脏预后

[Retrospective analysis of Henoch-Schonlein purpura in children: diagnostic difficulties and renal outcome].

作者信息

Leone V, Corazzola B, Milocco C, Facchini S, Ciambra R, Cerasoli G, Pocecco M

机构信息

Unità Operativa di Pediatria e Patologia Neonatale Ospedale Bufalini, Cesena.

出版信息

Pediatr Med Chir. 2002 Jul-Aug;24(4):284-8.

PMID:12197086

Abstract

OBJECTIVE

To assess clinical presentation, diagnostic difficulties, natural history and prognostic indicators of renal involvement of Henoch Schönlein Purpura, a ten-years retrospective analysis of all patients case records was performed.

METHODS

After a variable interval of 1 to 10 years following the vasculitic episode all the children came to the outpatient clinic for history taking, clinical examination, blood pressure measurements, urine analysis and renal function assessment.

RESULTS

54 children, mean age 5.9 +/- 2.5, were identified. The purpuric rash was associated with arthritis in 46 patients (85%), abdominal pain in 28 (51.8%), temperature > 38 degrees C in 11 (20%). The purpuric rash was present at on presentation in 39 subjects (72%) whereas in 15 children (28%) it followed the subsequent signs or symptoms that were arthritis in 8 (53.3%), joint pain in 2 (13.3%), abdominal pain in 5 (30.3%). Abdominal pain was the only symptom of presentation in 5 patients; two of them underwent surgical laparotomy.

摘要

目的

为评估过敏性紫癜肾受累的临床表现、诊断难点、自然病程及预后指标，对所有患者的病例记录进行了一项为期十年的回顾性分析。

方法

在血管炎发作后的1至10年不等的时间间隔后，所有儿童前来门诊进行病史采集、临床检查、血压测量、尿液分析和肾功能评估。

结果

确定了54名儿童，平均年龄5.9 +/- 2.5岁。46例患者（85%）的紫癜皮疹与关节炎有关，28例（51.8%）与腹痛有关，11例（20%）体温>38摄氏度。39名受试者（72%）在就诊时出现紫癜皮疹，而在15名儿童（28%）中，紫癜皮疹出现在随后的体征或症状之后，其中8例（53.3%）为关节炎，2例（13.3%）为关节痛，5例（30.3%）为腹痛。5例患者仅以腹痛为就诊症状；其中2例接受了外科剖腹手术。