Desinor-Mompoint O I, García-De la Puente S, de León-Bojorge B, Pablos-Hach J L, Zaltzman-Girshevych S
Servicio de Nefrología, Instituto Nacional de Pediatría, México, D.F.
Bol Med Hosp Infant Mex. 1991 Oct;48(10):730-5.
Over one hundred patients diagnosed with vascular purpura at the National Institute of Pediatrics between 1979 and 1988 were retrospectively studied. Frequency was similar for both sexes. 82% were between the ages of six months and 11 years old. The extrarenal clinical manifestations were: petechias in 98%; abdominal pain 78% arthralgias 45%; melena 39%; and arthritis in 19% of the cases, 49 patients had nephropathy of different degrees and they did differently, 32 had hematuria with or without proteinuria within a nephrotic range, seven suffered from a nephrotic syndrome, one with a nephritic syndrome and nine others had a combination of two or three syndromes (nephritic/nephrotic/renal failure) with an unfavorable evolution towards terminal renal failure in eight of them; on the other hand, this was not seen in the remaining patients. Thirteen renal biopsies were taken from patients with more severe clinical manifestations, finding in them mesangial proliferation or endo- and extracapillary proliferation. These findings suggest that the initial clinical presentation of the illness allows for the prediction of the future.
对1979年至1988年间在国立儿科学研究所诊断为血管性紫癜的一百多名患者进行了回顾性研究。男女发病率相似。82%的患者年龄在6个月至11岁之间。肾外临床表现为:瘀点98%;腹痛78%;关节痛45%;黑便39%;关节炎19%。49例患者有不同程度的肾病,表现各异,32例有血尿伴或不伴肾病范围内的蛋白尿,7例患有肾病综合征,1例患有肾炎综合征,另外9例有两种或三种综合征(肾炎/肾病/肾衰竭)的组合,其中8例病情进展不利,最终发展为终末期肾衰竭;另一方面,其余患者未出现这种情况。对临床表现较严重的患者进行了13次肾活检,发现系膜增生或毛细血管内和毛细血管外增生。这些发现表明,该疾病的初始临床表现有助于预测其未来发展。