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高压电烧伤后并发过敏性紫癜:一例报告并文献复习

Henoch-Schönlein purpura following high-voltage electric burn injury: A case report and review of the literature.

作者信息

Duan Xunhong, Yu Dongqi, Yu Changlong, Wang Biao, Guo Yibin

机构信息

Department of Burns and Plastic Surgery, The 175th Hospital of PLA, Affiliated Southeast Hospital of Xiamen University, Zhangzhou, Fujian 363000, P.R. China.

出版信息

Exp Ther Med. 2016 Feb;11(2):540-542. doi: 10.3892/etm.2015.2905. Epub 2015 Dec 2.

Abstract

Henoch-Schönlein Purpura (HSP) is a systemic vasculitis of unknown cause, with immune-mediated inflammation of the small vessels, which is characterized by a series of clinical symptoms, such as purpuric rash, colicky abdominal pain, arthritis and acute glomerulonephritis. Twenty-one days following a high-voltage electrical burn injury, a 40-year-old man developed classic clinical symptoms of HSP, including purpuric rash on bilateral lower extremities and abdominal pain. The patient was diagnosed with HSP associated with high-voltage burn injury, which is an extremely rare phenomenon. The diagnosis was based on the clinical manifestations of purpuric rash, abdominal pain and arthralgia, as well as the findings of laboratory examinations [increased levels of serum immunoglobulin A (11.6g/l) and complements C3 (9.6 g/l) and C4 (7.6 g/l), and a positive fecal occult blood test]. The patient was treated with antihistamines (loratadine tablets; 10 mg/day), anti-inflammatory medication (methylprednisolone sodium succinate; 40 mg/day) and oral omeprazole magnesium. The symptoms gradually decreased within 2 weeks from treatment and no abnormality was observed at the 3-, 6- and 12-month follow-ups. In patients who have suffered an electrical burn injury, this autoimmune disease may be caused by long-term inflammation. Therefore, examination of the liver and kidney functions of such patients is important in order to decrease the risk of post-traumatic immune system dysfunction.

摘要

过敏性紫癜(HSP)是一种病因不明的系统性血管炎,由小血管的免疫介导性炎症引起,其特征为一系列临床症状,如紫癜性皮疹、绞痛性腹痛、关节炎和急性肾小球肾炎。一名40岁男性在高压电烧伤后21天出现了HSP的典型临床症状,包括双下肢紫癜性皮疹和腹痛。该患者被诊断为与高压烧伤相关的HSP,这是一种极为罕见的现象。诊断基于紫癜性皮疹、腹痛和关节痛的临床表现以及实验室检查结果[血清免疫球蛋白A水平升高(11.6g/l)、补体C3(9.6g/l)和C4(7.6g/l),粪便潜血试验阳性]。患者接受了抗组胺药(氯雷他定片;10mg/天)、抗炎药物(甲泼尼龙琥珀酸钠;40mg/天)和口服奥美拉唑镁治疗。治疗后2周内症状逐渐减轻,在3个月、6个月和12个月的随访中未观察到异常。对于遭受电烧伤的患者,这种自身免疫性疾病可能由长期炎症引起。因此,检查此类患者的肝肾功能对于降低创伤后免疫系统功能障碍的风险很重要。

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