Children's Hospital of Atlanta, Atlanta, GA, USA.
J Investig Med High Impact Case Rep. 2020 Jan-Dec;8:2324709620947608. doi: 10.1177/2324709620947608.
Leukocytoclastic vasculitis (LCV) is a rare vascular inflammatory condition that affects post-capillary venules. Its incidence in the pediatric population is unknown. However, its incidence has been shown to increase with age. The causes of LCV can be varied, ranging from drugs to infections to systemic disease. LCV as a presenting symptom of inflammatory bowel disease (IBD) is rare, especially in the pediatric population. A 15-year-old female with a family history of systemic lupus erythematosus was transferred to our hospital with a month-long history of rash, joint swelling and tenderness, periorbital edema, weight loss, and diarrhea. She presented with the objective findings of a biopsy showing LCV and a computed tomography scan read that was concerning for IBD versus infectious colitis. She had a thorough workup, involving both the rheumatology and gastroenterology services, and was ultimately found to have Crohn's disease. This case reveals the importance of recognition of a constellation of symptoms in IBD even when they are not classical in nature at initial presentation.
白细胞碎裂性血管炎（LCV）是一种罕见的血管炎症性疾病，影响小静脉后毛细血管。其在儿科人群中的发病率尚不清楚。然而，其发病率随着年龄的增长而增加。LCV 的病因多种多样，从药物到感染到全身性疾病都有。LCV 作为炎症性肠病（IBD）的首发症状较为罕见，尤其是在儿科人群中。一名有系统性红斑狼疮家族史的 15 岁女性因皮疹、关节肿胀和压痛、眶周水肿、体重减轻和腹泻长达一个月而转入我院。她的活检显示白细胞碎裂性血管炎，计算机断层扫描显示有炎症性肠病的可能，而不是感染性结肠炎。她进行了全面的检查，涉及风湿科和消化科，最终被诊断为克罗恩病。本病例揭示了即使在初始表现不典型时，识别 IBD 的一系列症状的重要性。
