Karakayali Burcu, Yilmaz Sila, Çakir Deniz, Günes Pembe Gül, Güven Sirin, Islek Ismail
University of Health Sciences, Umraniye Research and Training Hospital, Department of Pediatrics, Istanbul, Turkey.
Haydarpasa Numune Research and Training Hospital, Department of Pathology, Istanbul, Turkey.
Pan Afr Med J. 2017 May 11;27:29. doi: 10.11604/pamj.2017.27.29.10481. eCollection 2017.
Henoch-Schönlein purpura (HSP) is the most common form of childhood vasculitis. Various viral and bacterial infections, drugs, vaccines, food allergy and even insect bites have been considered as triggering factors in pathogenesis of HSP. Epstein-Barr virus (EBV) infection, which is associated with HSP, have been rarely reported. Herein we present HSP patient possibly caused by EBV infection. A 8-year old boy was admitted to our department with fever, rashes on legs and arms and intermittent mild abdominal pain. Multiple purpuric rashes were on his extremities, abdomen and buttock. Laboratory investigations revealed that monospot test was positive, EBV serology tests; Anti-EA-D Ig G: 3+, Anti-VCA gp125 Ig G: 3+, Anti-VCA p19 Ig M: 2+, Anti EBNA-1 Ig M: negative, Anti EBNA-1 Ig M: negative, Anti EBNA-1 Ig G: negative. The patient was interpreted as the primary active acute EBV infection. A skin biopsy showed leucocytoclastic vasculitis. The other viral and bacterial investigations were negative. The patient was diagnosed as HSP vasculitis according to EULAR criteria and treated with intravenous hydration and ibuprofen. He was discharged after 15 days with normal laboratory findings and physical examination. We think that EBV infection may be stimulant factor for autoimmune reactions and may cause HSP vasculitis. Hence, it may be useful to investigate the EBV infection in etiology of HSP cases.
过敏性紫癜（HSP）是儿童血管炎最常见的形式。多种病毒和细菌感染、药物、疫苗、食物过敏甚至蚊虫叮咬都被认为是HSP发病机制中的触发因素。与HSP相关的EB病毒（EBV）感染鲜有报道。在此我们报告一例可能由EBV感染引起的HSP患者。一名8岁男孩因发热、腿部和手臂出现皮疹以及间歇性轻度腹痛入院。其四肢、腹部和臀部有多处紫癜性皮疹。实验室检查显示嗜异性凝集试验呈阳性，EBV血清学检测结果为：抗EA-D IgG：3+，抗VCA gp125 IgG：3+，抗VCA p19 IgM：2+，抗EBNA-1 IgM：阴性，抗EBNA-1 IgG：阴性。该患者被诊断为原发性活动性急性EBV感染。皮肤活检显示白细胞破碎性血管炎。其他病毒和细菌检查均为阴性。根据欧洲抗风湿病联盟（EULAR）标准，该患者被诊断为HSP血管炎，并接受了静脉补液和布洛芬治疗。15天后，患者实验室检查结果和体格检查均正常，随后出院。我们认为EBV感染可能是自身免疫反应的刺激因素，可能导致HSP血管炎。因此，在HSP病例的病因学中研究EBV感染可能会有所帮助。
