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[儿童过敏性血管炎]

[Allergic vasculitis in children].

作者信息

Bodemer C

机构信息

Service de Dermatologie, Hôpital Necker-Enfants Malades, Paris.

出版信息

Ann Pediatr (Paris). 1992 Sep;39(7):426-34.

PMID:1416664
Abstract

Allergic vasculitis is characterized clinically by vascular purpura and histologically by leukocytoclastic angiitis of the small vessels in the middle and superficial dermis. Extra-cutaneous lesions may occur. Among them, the most common are joint manifestations. Renal involvement governs the prognosis. Circulating immune complexes probably contribute to the development of lesions, although this role has not been firmly established. Cellular immunity is probably also involved. A large number of factors may trigger the development of allergic vasculitis. Clinical patterns vary widely across patients. In 50% of patients no cause is identified. In children, Henoch-Schönlein purpura and infections (viral or bacterial) are the most common "causes". The ideal treatment would be elimination of the causative allergen. However this is often impossible to achieve and a variety of symptomatic treatments (rest, dapsone, colchicine, corticosteroids, immunosuppressants...) may be discussed according to the severity of clinical manifestations. Effectiveness of these treatments is variable.

摘要

变应性血管炎的临床特征为血管性紫癜,组织学特征为真皮中层和浅层小血管的白细胞破碎性血管炎。可出现皮肤外病变。其中,最常见的是关节表现。肾脏受累决定预后。循环免疫复合物可能参与病变的发生,尽管这一作用尚未得到确凿证实。细胞免疫可能也有涉及。大量因素可触发变应性血管炎的发生。不同患者的临床模式差异很大。50%的患者病因不明。在儿童中,过敏性紫癜和感染(病毒或细菌)是最常见的“病因”。理想的治疗方法是消除致病过敏原。然而,这往往无法实现,可根据临床表现的严重程度讨论多种对症治疗方法(休息、氨苯砜、秋水仙碱、皮质类固醇、免疫抑制剂等)。这些治疗方法的有效性各不相同。

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