Angelier A-S, Petit L, Wynckel A, Vuiblet V, Birembaut P, Toubas O, Lebargy F, Deslee G
Service des maladies respiratoires, IFR 53, hôpital Maison-Blanche, CHU de Reims, 45 rue Cognacq-Jay, Reims, France.
Rev Mal Respir. 2011 Mar;28(3):372-6. doi: 10.1016/j.rmr.2010.09.033. Epub 2011 Feb 23.
Schoenlein-Henoch purpura is a systemic vasculitis involving the small vessels. In adults it is rare and is sometimes associated with malignancies such as bronchial carcinoma. We report the case of a 74-year-old male ex smoker who was admitted with necrotic skin lesions associated with a nephrotic syndrome, and was found to have a right upper lobe squamous cell bronchial carcinoma. The renal biopsy led to a diagnosis of IgA nephropathy related to Schoenlein-Henoch purpura. Curative surgical resection of the bronchial carcinoma (ypT2N0M0) was associated with remission of the purpura. The synchronous diagnosis of bronchial carcinoma and Schoenlein-Henoch purpura suggests a potential relationship between these two pathologies. Our observation and other published data strongly suggest a direct link on account of: the synchronous diagnosis, the clinical and biological remission of the Schoenlein-Henoch purpura after curative treatment of the bronchial carcinoma. It is important to recognise both the therapeutic and prognostic significance of this connection.
舍恩莱因-亨诺赫紫癜是一种累及小血管的系统性血管炎。在成人中较为罕见,有时与支气管癌等恶性肿瘤相关。我们报告了一例74岁的男性戒烟者,因伴有肾病综合征的坏死性皮肤病变入院,被发现患有右上叶鳞状细胞支气管癌。肾活检诊断为与舍恩莱因-亨诺赫紫癜相关的IgA肾病。支气管癌的根治性手术切除(ypT2N0M0)与紫癜的缓解相关。支气管癌与舍恩莱因-亨诺赫紫癜的同步诊断提示这两种病理之间可能存在关联。我们的观察以及其他已发表的数据强烈表明存在直接联系,原因如下:同步诊断、支气管癌根治性治疗后舍恩莱因-亨诺赫紫癜的临床和生物学缓解。认识到这种关联的治疗和预后意义很重要。