Frigui Makram, Kechaou Manel, Ben Hmida Mohamed, Kamoun Khaoula, Khanfir Afef, Frikha Mounir, Hachicha Jamil, Bahloul Zouhir
Service de médecine interne, CHU Hédi-Chaker, route Ain Km 0,5, 3029 Sfax, Tunisie.
Nephrol Ther. 2009 Jun;5(3):201-4. doi: 10.1016/j.nephro.2008.11.001. Epub 2009 Feb 13.
Association between Schönlein-Henoch purpura and neoplasm can suggest the responsibility of tumour antigens in the genesis of the vasculitis. We report a new case of squamous cell carcinoma associated with Schönlein-Henoch purpura and we discuss the reality of this association.
We report the case of a 50-year-old man who presents Schönlein-Henoch purpura with a purpura of lower limbs, joint involvement, gastrointestinal lesions and IgA renal mesangial deposits. The patient received three intravenous methylprednisolone pulses followed with oral corticosteroids. Six months later, while the vasculitis was in remission, the patient presented a squamous cell lung carcinoma. He was treated by chemotherapy and local radiotherapy. At the late follow-up, the neoplasm was incompletely resolved.
The neoplasm could be responsible of the development of the Schönlein-Henoch purpura. The discovery of this systemic vasculitis in an elderly patient should warrant a deep screening for an occult neoplasm.
过敏性紫癜与肿瘤之间的关联提示肿瘤抗原在血管炎发病机制中的作用。我们报告一例与过敏性紫癜相关的鳞状细胞癌新病例,并讨论这种关联的实际情况。
我们报告一名50岁男性病例,该患者患有过敏性紫癜,伴有下肢紫癜、关节受累、胃肠道病变及IgA系膜沉积。患者接受了三次静脉注射甲泼尼龙冲击治疗,随后口服皮质类固醇。六个月后,当血管炎缓解时,患者出现了鳞状细胞肺癌。他接受了化疗和局部放疗。在后期随访中,肿瘤未完全消退。
肿瘤可能是过敏性紫癜发病的原因。在老年患者中发现这种系统性血管炎应促使对隐匿性肿瘤进行深入筛查。