Yoshino Jun, Sasamura Hiroyuki, Konishi Kohnosuke, Tsuji Mihoko, Suda Noriko, Yoshida Testuya, Monkawa Toshiaki, Hayashi Matsuhiko, Itoh Hiroshi
Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan.
Nihon Jinzo Gakkai Shi. 2007;49(1):49-53.
Henoch-Schönlein purpura(HSP) is a systemic vasculitis and characterized by the tissue deposition of IgA-containing immune complexes. A 50-year-old man with end stage renal failure due to diabetic nephropathy on maintenance hemodialysis, presented purpura, hematuria, abdominal pain, and joint pain. He also presented a high fever with neutrophilia. Biopsy of skin lesions revealed inflammation of the small vessel accompanied by vascular IgA deposition. Based on the clinical symptoms and skin biopsy, we made the diagnosis of HSP. Oral prednisolone was administered resulting in an improvement of the clinical symptoms. A skin biopsy should be performed for histological and immunofluorescence studies in the case of clinical suspicion of HSP with end stage renal disease on hemodialysis.
过敏性紫癜（HSP）是一种系统性血管炎，其特征为含IgA免疫复合物在组织中沉积。一名50岁因糖尿病肾病导致终末期肾衰竭并接受维持性血液透析的男性，出现紫癜、血尿、腹痛和关节痛。他还伴有高热和中性粒细胞增多。皮肤病变活检显示小血管炎症伴血管IgA沉积。根据临床症状和皮肤活检，我们诊断为HSP。给予口服泼尼松龙后临床症状有所改善。对于临床怀疑患有HSP且正在接受血液透析的终末期肾病患者，应进行皮肤活检以进行组织学和免疫荧光研究。
