Trapani Sandra, Rubino Chiara, Indolfi Giuseppe
Department of Health Sciences, University of Florence and Meyer Children's University Hospital, Florence, Italy.
Post-graduate School of Pediatrics, University of Florence, Florence, Italy.
Acta Paediatr. 2020 Nov;109(11):2226-2236. doi: 10.1111/apa.15381. Epub 2020 Jul 1.
The aim of this narrative review was to provide a comprehensive summary of the characteristics of gastrointestinal (GI) involvement in the most common paediatric primary vasculitides.
We used PubMed to primarily identify papers, reviews, case series and editorials published in English from 2000 until 31 January 2020. Based on this, we report the prevalence, clinical manifestations, diagnostic approaches and management of GI involvement in each vasculitis.
Vasculitides are inflammatory blood vessel diseases, and the majority can affect the GI system with vascular, GI tract or solid organ involvement. GI involvement can sometimes complicate and delay the correct diagnosis. Clinical findings are usually nonspecific symptoms, such as fever, abdominal pain, nausea, vomiting and diarrhoea. Bleeding should alert paediatricians to the possibility of severe complicated vasculitis. Diagnosis relies mostly on imaging. If it goes unrecognised, GI involvement in paediatric vasculitis is a serious cause of morbidity and even mortality, related to bowel ischaemia and perforation. Treatment of GI symptoms depends on the type of vasculitis and usually involves high-dose steroids and immunosuppressants.
GI manifestations in the most common paediatric primary vasculitides were usually nonspecific, diagnosis mostly relied on imaging, and treatment usually involved high-dose corticosteroids and immunosuppressants.
本叙述性综述的目的是全面总结最常见的儿童原发性血管炎中胃肠道（GI）受累的特征。
我们使用PubMed主要检索2000年至2020年1月31日以英文发表的论文、综述、病例系列和社论。基于此，我们报告了每种血管炎中胃肠道受累的患病率、临床表现、诊断方法和管理。
血管炎是炎症性血管疾病，大多数可累及胃肠道系统，伴有血管、胃肠道或实体器官受累。胃肠道受累有时会使正确诊断复杂化并延迟诊断。临床发现通常是非特异性症状，如发热、腹痛、恶心、呕吐和腹泻。出血应提醒儿科医生注意严重复杂血管炎的可能性。诊断主要依靠影像学检查。如果未被识别，儿童血管炎中的胃肠道受累是发病甚至死亡的严重原因，与肠道缺血和穿孔有关。胃肠道症状的治疗取决于血管炎的类型，通常包括大剂量类固醇和免疫抑制剂。
最常见的儿童原发性血管炎中的胃肠道表现通常是非特异性的，诊断主要依靠影像学检查，治疗通常包括大剂量皮质类固醇和免疫抑制剂。
