Migita Makoto, Hayakawa Jun, Shima Hideki, Kobayashi Hiroyuki, Yamataka Atsutaka, Murakami Mutsumi, Miyano Takeshi, Fukunaga Yoshitaka
Department of Pediatrics, Nippon Medical School, Tokyo, Japan.
J Nippon Med Sch. 2005 Dec;72(6):383-6. doi: 10.1272/jnms.72.383.
A case of Henoch-Schönlein purpura (HSP) with necrosis of the small intestine, neurological symptoms, and pericardial tamponade after frequent recurrence is described. Neurological symptoms were controlled well with steroid pulse therapy, and pericardial tamponade was treated successfully with pericardiocentesis and steroid pulse therapy. To treat necrosis of the small intestine, the necrotic tissue was excised and artificial anuses were constructed. Five months later, the small intestine was anastomosed in a curative operation. Periodic administration of coagulation factor XIII was required from the onset of symptoms until curative surgery, but the activity of this factor returned to normal levels after surgery operation. We report a case of Henoch-Schönlein purpura with extremely rare complications: necrosis of the small intestine, neurological symptoms, and pericardial tamponade.
本文描述了一例复发性过敏性紫癜(HSP),伴有小肠坏死、神经症状和心包填塞。神经症状通过类固醇冲击疗法得到良好控制,心包填塞通过心包穿刺术和类固醇冲击疗法成功治疗。为治疗小肠坏死,切除了坏死组织并造了人工肛门。五个月后,进行了根治性手术,将小肠吻合。从症状出现到根治性手术期间需要定期给予凝血因子 XIII,但手术后该因子的活性恢复到正常水平。我们报告了一例伴有极其罕见并发症的过敏性紫癜病例:小肠坏死、神经症状和心包填塞。