[以IgA血管炎为首发表现的急性胰腺炎：一种不寻常的表现]

[Acute pancreatitis as the presenting feature of an IgA vasculitis: An unusual presentation].

作者信息

Fertitta L, Noel N, Ackermann F, Lerolle N, Benoist S, Rocher L, Lambotte O

机构信息

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.

出版信息

Rev Med Interne. 2017 Oct;38(10):691-694. doi: 10.1016/j.revmed.2017.01.012. Epub 2017 Feb 16.

DOI:10.1016/j.revmed.2017.01.012

PMID:28215926

Abstract

INTRODUCTION

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.

CASE REPORT

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.

CONCLUSION

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.

摘要