Ahn Jong Gyun
Department of Pediatrics, Severance Children's Hospital, Seoul, Korea.
Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea.
J Rheum Dis. 2024 Jul 1;31(3):135-142. doi: 10.4078/jrd.2024.0045. Epub 2024 Jun 5.
Pediatric vasculitis and adult vasculitis differ in several aspects. While both involve inflammation of blood vessels, pediatric vasculitis tends to present with distinct clinical features and may involve different types of blood vessels compared to adult vasculitis. Despite its relatively rare occurrence compared to adult vasculitis, pediatric vasculitis warrants careful attention due to its potential for profound and diverse clinical manifestations, ranging from mild cutaneous symptoms to life-threatening systemic complications. Childhood vasculitis should be suspected in children who present symptoms attributable to systemic inflammation and complications arising from multi-organ dysfunction. However, achieving a diagnosis necessitates thorough exclusion of alternative conditions manifesting similar symptoms and findings. Hence, children suspected of vasculitis should undergo meticulous history-taking, comprehensive physical examination, and requisite laboratory investigations, imaging studies, and sometimes tissue biopsies to elucidate the diagnosis. Early detection and treatment of childhood vasculitis are crucial, as the condition can affect various organs and potentially lead to life-threatening complications or long-term sequelae in adulthood if left untreated. This review aimed to provide an exhaustive overview of childhood vasculitis, outlining its epidemiology, classification, clinical presentation, diagnostic modalities, therapeutic strategies and outcome.
儿童血管炎和成人血管炎在几个方面存在差异。虽然两者都涉及血管炎症,但与成人血管炎相比,儿童血管炎往往呈现出独特的临床特征,且可能累及不同类型的血管。尽管与成人血管炎相比其发病率相对较低,但儿童血管炎因其可能出现从轻微皮肤症状到危及生命的全身并发症等广泛而多样的临床表现,值得密切关注。对于出现全身炎症症状以及多器官功能障碍引发并发症的儿童,应怀疑患有儿童血管炎。然而,要做出诊断必须彻底排除表现出类似症状和体征的其他疾病。因此,疑似血管炎的儿童应接受详细的病史询问、全面的体格检查以及必要的实验室检查、影像学检查,有时还需要进行组织活检以明确诊断。儿童血管炎的早期发现和治疗至关重要,因为该疾病可累及多个器官,如果不进行治疗,成年后可能会导致危及生命的并发症或长期后遗症。本综述旨在全面概述儿童血管炎,阐述其流行病学、分类、临床表现、诊断方法、治疗策略及预后。