Torres Juliana, de Oliveira Sheila, de Almeida Rozana, Pelajo Christina, Sztajnbok Flávio, Rodrigues Marta Cristine
Instituto de Puericultura e Pediatria Martagão Gesteira-Universidade Federal do Rio de Janeiro, Médica pediatra - Especialização em reumatologia pediátrica.
Acta Reumatol Port. 2007 Oct-Dec;32(4):377-80.
Henoch-Schonlein purpura is one of the most common vasculitis in children. Some microorganisms have being suggested as possible etiological agents as group A streptococcus.
R.L.B 7 years old presented with purpuric lesions in lower extremities and buttocks following fever and polyarthritis. After 7 days he arrived in our hospital showing pharyngitis new systolic murmur migratory polyarthritis and palpable purpura. His urinalysis had raised proteins and white cell count hemogram was normal sedimentation rate and streptococcal antibody titer were elevated. Electrocardiography showed a prolonged PR interval and echocardiogram confirmed moderate to severe mitral valve regurgitation. The patient was treated with prednisone 2mg kg day and penicillin G benzathine with clinical and laboratorial improvement.
Literature reports HSP associated with rheumatic fever and carditis. Our case adds further evidence to the possibility of streptococcus being a causal agent of HSP.
过敏性紫癜是儿童最常见的血管炎之一。一些微生物被认为可能是病因，如A组链球菌。
7岁的R.L.B在发热和多关节炎后出现下肢及臀部紫癜性病变。7天后他来到我院，表现为咽炎、新出现的收缩期杂音、游走性多关节炎和可触及的紫癜。他的尿液分析显示蛋白升高和白细胞计数升高，血常规正常，血沉和链球菌抗体滴度升高。心电图显示PR间期延长，超声心动图证实有中度至重度二尖瓣反流。患者接受泼尼松2mg/（kg·天）和苄星青霉素治疗，临床和实验室检查结果均有改善。
文献报道过敏性紫癜与风湿热和心脏炎有关。我们的病例进一步证明了链球菌可能是过敏性紫癜的病因。
