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儿童过敏性紫癜胃肠症状的视频胶囊内镜特点。

The characteristics of video capsule endoscopy in pediatric Henoch-Schönlein purpura with gastrointestinal symptoms.

机构信息

Department of gastroenterology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, 3333 Bin Sheng Road, Hangzhou, 310052, Zhejiang Province, China.

出版信息

Pediatr Rheumatol Online J. 2020 Oct 28;18(1):84. doi: 10.1186/s12969-020-00471-4.

Abstract

BACKGROUND

Henoch-Schönlein purpura (HSP) is a systemic small-vessel vasculitis also named IgA vasculitis that commonly affects the gastrointestinal tract. The video capsule endoscopy (VCE) characteristics of pediatric HSP patients are rarely reported.

METHODS

Patients diagnosed with HSP and analyzed by VCE examination at our hospital from February 2010 to January 2019 are enrolled. The clinical features, laboratory findings, and the characteristics of VCE findings are studied.

RESULTS

There are 30 patients enrolled in this investigation from February 2010 to January 2020. The mean age of these patients is 96.9 ± 35.8 months, and the most frequent finding of VCE is mucosal erosion, which account for 79.3% of the patients, and followed by mucosal erythema or petechia accounted for 69% of the patients. Regarding the disease location detected by endoscopy, jejunum is the most common involved part of the gastrointestinal tract in pediatric HSP patients. All the patients had the jejunum involved except in one patient the VCE did not pass through the pylorus. One third of the patients involved the descending portion of duodenum. No side effect is observed in this study.

CONCLUSIONS

VCE may be an excellent adjust tool for evaluation of the gastrointestinal tract in children with abdominal symptoms without typical purpura in suspected pediatric HSP patients. VCE appears to be superior to esophagogastroduodenoscopy in detecting small intestinal lesions of HSP and has an excellent safety profile.

摘要

背景

过敏性紫癜(HSP)是一种系统性小血管血管炎,也称为 IgA 血管炎,常累及胃肠道。儿科 HSP 患者的视频胶囊内镜(VCE)特征鲜有报道。

方法

本研究纳入了 2010 年 2 月至 2019 年 1 月期间在我院接受 HSP 诊断和 VCE 检查的患者。研究分析了患者的临床特征、实验室检查结果和 VCE 检查结果的特点。

结果

本研究共纳入了 30 例患者,平均年龄为 96.9±35.8 个月。VCE 最常见的表现是黏膜糜烂,占 79.3%,其次是黏膜红斑或瘀点,占 69%。在 VCE 检测到的内镜疾病部位中,空肠是儿科 HSP 患者胃肠道最常见的受累部位。除了 1 例患者因 VCE 未能通过幽门而未累及空肠外,所有患者均累及空肠。三分之一的患者累及十二指肠降部。本研究未观察到任何不良反应。

结论

对于疑似儿科 HSP 患者伴有腹部症状但无典型紫癜的患儿,VCE 可能是评估胃肠道的一种极好的调整工具。VCE 在检测 HSP 的小肠病变方面优于食管胃十二指肠镜,且具有极好的安全性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/881b/7592546/b3ed513ecf4b/12969_2020_471_Fig1_HTML.jpg

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