Fertitta L, Noel N, Ackermann F, Lerolle N, Benoist S, Rocher L, Lambotte O
Service de médecine interne et immunologie clinique, hôpital universitaire de Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France.
Service de médecine interne et immunologie clinique, hôpital universitaire de Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94275 Le Kremlin-Bicêtre, France; Faculté de médecine, université Paris-Sud, 94275 Le Kremlin-Bicêtre, France; IDMIT, CEA, DSV/iMETI, division d'immunovirologie, 92260 Fontenay-aux-Roses, France; Inserm, U1184, centre d'immunologie des maladies virales et autoimmunes, 94275 Le Kremlin-Bicêtre, France.
Rev Med Interne. 2017 Oct;38(10):691-694. doi: 10.1016/j.revmed.2017.01.012. Epub 2017 Feb 16.
IgA vasculitis is a systemic small vessel leukocytoclastic vasculitis characterized by skin purpura, arthritis, abdominal pain and nephritis. Most of the abdominal complications are due to edema and hemorrhage in the small bowel wall, but rarely to acute secondary pancreatitis.
Here, we report a 53-year-old woman who presented with acute pancreatitis and, secondarily, developed skin purpura and arthritis at the seventh day of the clinical onset. Biological tests and computed tomographic scan allowed to rule out another cause of pancreatitis and IgA vasculitis was diagnosed as its etiology. The outcome was favorable without any relapse on glucocorticoids.
Despite its rarity, pancreatitis is a potential life-threatening complication of IgA vasculitis in which the role of glucocorticoids and immunosuppressive drugs remains uncertain. A prompt elimination of other usual pancreatitis etiologies is mandatory to improve the management of the patients.
IgA血管炎是一种系统性小血管白细胞破碎性血管炎，其特征为皮肤紫癜、关节炎、腹痛和肾炎。大多数腹部并发症是由于小肠壁水肿和出血，但急性继发性胰腺炎很少见。
在此，我们报告一名53岁女性，她以急性胰腺炎为首发症状，在临床发病第7天继发皮肤紫癜和关节炎。生物学检查和计算机断层扫描排除了胰腺炎的其他病因，IgA血管炎被诊断为病因。患者预后良好，使用糖皮质激素后未复发。
尽管胰腺炎罕见，但它是IgA血管炎潜在的危及生命的并发症，糖皮质激素和免疫抑制药物在其中的作用仍不确定。必须迅速排除其他常见的胰腺炎病因，以改善患者的治疗。
