成人腹型过敏性紫癜伴腹痛和胃肠道出血对糖皮质激素的良好反应：一份CARE病例报告
A good response to glucocorticoid for Henoch-Schönlein purpura with abdominal pain and gastrointestinal bleeding in an adult: A CARE case report.
作者信息
Yi Fangfang, Bai Zhaohui, Li Yingying, Xu Xiangbo, Guo Xiaozhong, Qi Xingshun
机构信息
Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang.
Postgraduate College, Dalian Medical University, Dalian.
出版信息
Medicine (Baltimore). 2020 Jan;99(1):e18602. doi: 10.1097/MD.0000000000018602.
RATIONALE
Henoch-Schönlein purpura (HSP) is a small-vessel vasculitis that has been extensively studied in children, but little is known about its natural history in adults. There is no consensus regarding the treatment of glucocorticosteroids use for HSP. The efficacy of glucocorticoid for preventing from severe complications or relapse is also controversial in HSP.
PATIENT CONCERNS
A 21-year-old male was admitted to the hospital due to abdominal pain for more than 20 days, hematochezia for more than 10 days, and rash for 2 days.
DIAGNOSES
The diagnosis of HSP is based on the European League against Rheumatism and the Paediatric Rheumatology European Society in 2006.
INTERVENTIONS
The patient received glucocorticosteroids treatment for 17 days at the time of first hospitalization.
OUTCOMES
The abdominal pain and hematochezia completely disappeared on the 6th day after the use of glucocorticosteroids, and purpura completely disappeared on the 8th day.
LESSONS
Our patient has a good response to glucocorticoid. Glucocorticosteroids may be effective for the treatment of HSP.
理论依据
过敏性紫癜（HSP）是一种小血管炎，在儿童中已有广泛研究，但在成人中的自然病史知之甚少。对于HSP使用糖皮质激素治疗尚无共识。糖皮质激素预防严重并发症或复发的疗效在HSP中也存在争议。
患者情况
一名21岁男性因腹痛20余天、便血10余天、皮疹2天入院。
诊断
HSP的诊断依据2006年欧洲抗风湿病联盟和欧洲儿科风湿病学会的标准。
干预措施
患者首次住院时接受了17天的糖皮质激素治疗。
结果
使用糖皮质激素后第6天腹痛和便血完全消失，第8天紫癜完全消失。
经验教训
我们的患者对糖皮质激素反应良好。糖皮质激素可能对HSP治疗有效。
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