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以急腹症为表现的过敏性紫癜

Henoch-Schönlein Purpura Presenting with Acute Abdomen.

作者信息

Catal Oguz, Ozer Bahri, Sit Mustafa

机构信息

Department of General Surgery, Abant Izzet Baysal University Hospital, Bolu, Turkey.

出版信息

J Coll Physicians Surg Pak. 2021 Mar;31(3):350-352. doi: 10.29271/jcpsp.2021.03.350.

DOI:10.29271/jcpsp.2021.03.350
PMID:33775032
Abstract

Henoch-Schönlein Purpura (HSP) is an autoimmune, systemic, non-granulomatous vasculitis characterised by self-limiting clinical course, and leukocytoclastic vasculitis of small vessels. Deposition of immune complexes that contain IgA is the hallmark of vascular involvement. Adults with HSP have a higher incidence of complications and death. The most common gastrointestinal (GI) symptom of HSP is abdominal pain. Vasculitis-related colitis, causing extensive lower GI hemorrhage, is uncommon in the course of HSP, which increases the risk of renal involvement. Here, we present two cases of HSP with GI involvement. In the first case, surgery was performed.  Whereas, the other patient was treated medically due to the experience gained from the first case. The HSP has no specific treatment. Most of the cases are mild and need only supportive care due to its self-limiting nature. Although corticosteroids do not prevent recurrences, evidence in literature suggests that these are beneficial in resolution of the arthritis and abdominal pain. Aggressive therapy with corticosteroids or cyclophosphamide is not successful in reducing renal damage, except in patients with crescentic nephritis. Key Words: Henoch-Schönlein purpura, Gastrointestinal complications, Steroids, Surgery.

摘要

过敏性紫癜(HSP)是一种自身免疫性、全身性、非肉芽肿性血管炎,其临床病程自限,以小血管白细胞破碎性血管炎为特征。含有IgA的免疫复合物沉积是血管受累的标志。成人过敏性紫癜患者并发症和死亡的发生率较高。过敏性紫癜最常见的胃肠道(GI)症状是腹痛。血管炎相关性结肠炎导致广泛的下消化道出血,在过敏性紫癜病程中并不常见,这增加了肾脏受累的风险。在此,我们报告两例伴有胃肠道受累的过敏性紫癜病例。第一例进行了手术。而另一例患者则根据第一例的经验接受了药物治疗。过敏性紫癜没有特效治疗方法。由于其自限性,大多数病例病情较轻,仅需支持治疗。虽然皮质类固醇不能预防复发,但文献证据表明,它们对缓解关节炎和腹痛有益。除新月形肾炎患者外,积极使用皮质类固醇或环磷酰胺治疗并不能成功减少肾脏损害。关键词:过敏性紫癜;胃肠道并发症;类固醇;手术

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