Konieczniak Karolina, Rekowski Filip Wantoch, Gładyś Anna, Zugajb Paweł, Rymarz Aleksandra, Niemczyk Stanisław
Department of Internal Disease, Nephrology and Dialysotherapy, Military Institute of Medicine, Warsaw, Poland.
Pol Merkur Lekarski. 2021 Apr 18;49(290):99-102.
Henoch-Schönlein-purpura (HSP) is a type of systemic vasculitis characterized by increased serum levels of IgA and the deposition of immune complexes mainly composed of IgA1. The cause of this disease has not yet been known. HSP mainly affects the pediatric population. In adults it is associated with a more aggressive course. A characteristic symptom of most patients is a petechial rash, often coexisting with joint pain and abdominal pain.
The aim of the study was to present the clinical picture and therapeutic possibilities of adult patients diagnosed with HSP.
A retrospective study was carried out in 8 adult patients with HSP, including 3 women and 5 men. The course of the disease, the degree of kidney damage and the effectiveness of the treatment were analyzed.
The mean value of nitrogen retention indexes in the studied group of patients was increased (creatinine: 1.47 ± 0.3 mg/dl, urea: 54.45 ± 9.02 mg/dl), no significant deviations were found in blood counts. In the general urine examination, hematuria was noted in 7 of 8 patients, proteinuria in 6 patients. Daily proteinuria was significantly increased (2498 ± 1031.69 mg/24h). 7 out of 8 patients had a diagnostic kidney biopsy. In 6 patients, the immunomorphological picture indicated glomerulonephritis in the course of IgA nephropathy. Six (75%) patients received immunosuppressive treatment, two (25%) conservative treatment.
The one-center retrospective one-year analysis of patients diagnosed with HSP shows that IgA-related vasculitis is a disease with a varied course, often causing diagnostic as well as therapeutic difficulties.
过敏性紫癜（HSP）是一种系统性血管炎，其特征为血清IgA水平升高以及主要由IgA1组成的免疫复合物沉积。该疾病的病因尚不明确。HSP主要影响儿童群体。在成人中，它与更具侵袭性的病程相关。大多数患者的一个特征性症状是瘀点皮疹，常伴有关节疼痛和腹痛。
本研究的目的是呈现成年过敏性紫癜患者的临床表现及治疗可能性。
对8例成年过敏性紫癜患者进行了回顾性研究，其中包括3名女性和5名男性。分析了疾病的病程、肾脏损害程度及治疗效果。
研究组患者的氮潴留指标平均值升高（肌酐：1.47±0.3mg/dl，尿素：54.45±9.02mg/dl），血细胞计数未发现明显偏差。尿常规检查中，8例患者中有7例出现血尿，6例出现蛋白尿。每日蛋白尿显著增加（2498±1031.69mg/24h）。8例患者中有7例进行了诊断性肾脏活检。6例患者的免疫形态学表现提示为IgA肾病过程中的肾小球肾炎。6例（75%）患者接受了免疫抑制治疗，2例（25%）接受了保守治疗。
对诊断为过敏性紫癜的患者进行的单中心回顾性一年分析表明，IgA相关血管炎是一种病程多样的疾病，常导致诊断和治疗困难。
