1 MD, Department of Pediatric Rheumatology, Cukurova University Faculty of Medicine, Turkey.
2 MD, Department of Pediatric Allergy and Immunology, Cukurova University Faculty of Medicine, Turkey.
Scott Med J. 2019 May;64(2):74-77. doi: 10.1177/0036933018809816. Epub 2018 Nov 19.
Henoch Schönlein purpura is characterised by palpable purpura, abdominal pain, arthritis/arthralgia, often with a self-limiting course. Herein, we report a patient with recurrent Henoch Schönlein purpura and severe gastrointestinal involvement, successfully treated with methotrexate.
A 12-year-old boy was admitted to our department with palpable purpura, abdominal pain and arthralgia. Since gastrointestinal complaints were severe, systemic steroids were administered, with tapering of dosage. Henoch Schönlein purpura recurred several times with severe abdominal pain, maelena and purpura during next two months. Colchicine and hydroxychloroquine were initiated. After four months, we also introduced methotrexate, which enabled discontinuation of previous medications including corticosteroids. Methotrexate was ceased four months later, and remission was sustained without any medications for 24 months.
Besides the conflicting data regarding the use of methotrexate in recurrent Henoch Schönlein purpura, our case introduces successful methotrexate experience in a child with Henoch Schönlein purpura and recurrent severe gastrointestinal involvement.
过敏性紫癜的特征为可触及性紫癜、腹痛、关节炎/关节痛，常呈自限性病程。在此，我们报告一例反复发作的过敏性紫癜伴严重胃肠道受累的患者，经甲氨蝶呤治疗后成功缓解。
一名 12 岁男孩因可触及性紫癜、腹痛和关节痛而被收入我科。由于胃肠道症状严重，给予全身皮质类固醇治疗，并逐渐减量。接下来两个月，过敏性紫癜反复发作，伴有严重腹痛、黑便和紫癜。给予秋水仙碱和羟氯喹治疗。四个月后，我们还开始使用甲氨蝶呤，从而停用了包括皮质类固醇在内的之前的药物。四个月后停用甲氨蝶呤，24 个月内无任何药物治疗而缓解。
除了关于甲氨蝶呤在反复发作的过敏性紫癜中使用的矛盾数据外，我们的病例还介绍了甲氨蝶呤在儿童反复发作的过敏性紫癜伴严重胃肠道受累中的成功应用经验。
