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16 个月大婴儿发生与肠套叠和高血压相关的链球菌后小血管血管炎:过敏性紫癜?

Post-streptococcal small-vessel vasculitis in a 16-month-old with associated intussusception and hypertension: Henoch Schönlein purpura?

机构信息

Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Section of Pediatric Dermatology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.

出版信息

Pediatr Dermatol. 2024 Sep-Oct;41(5):929-931. doi: 10.1111/pde.15599. Epub 2024 Apr 17.

Abstract

Henoch Schönlein purpura (HSP), also known as IgA vasculitis, is a systemic small-vessel vasculitis typically occurring in children 3-15 years of age, with peak incidence at 4-6 years. It is characterized by a constellation of symptoms including palpable purpura, arthralgias or arthritis, abdominal pain including intussusception, and renal involvement. We report a patient with these clinical findings whose IgA immunofluorescence was negative but with a presumptive diagnosis of HSP at 16 months of age, significantly younger than the classic population. This condition rarely affects this age group, and we highlight the importance of considering vasculitis in children of all ages, as a failure to diagnose could lead to insufficient long-term monitoring, particularly regarding renal function.

摘要

过敏性紫癜(HSP),又称 IgA 血管炎,是一种系统性小血管血管炎,通常发生在 3-15 岁的儿童中,发病高峰在 4-6 岁。其特征是一系列症状,包括可触及的紫癜、关节痛或关节炎、腹痛(包括肠套叠)和肾脏受累。我们报告了一例具有这些临床发现的患者,其 IgA 免疫荧光为阴性,但在 16 个月大时被拟诊为 HSP,明显比典型人群年轻。这种情况很少发生在这个年龄组,我们强调了在所有年龄段的儿童中都要考虑血管炎的重要性,因为漏诊可能导致长期监测不足,特别是肾功能监测不足。

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