Shayah Yamen, Almadhoun Osama, Pierce Drew, Lillvis John H, Abdul-Aziz Rabheh
Medical Education, Alfaisal University College of Medicine, Riyadh, SAU.
Pediatric Gastroenterology, University at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, USA.
Cureus. 2024 Sep 14;16(9):e69389. doi: 10.7759/cureus.69389. eCollection 2024 Sep.
Henoch-Schönlein purpura (HSP) is a systemic vasculitis characterized by palpable purpura, arthralgia or arthritis, GI symptoms, and renal involvement. Superior mesenteric artery (SMA) syndrome, a rare condition, occurs when the third part of the duodenum is compressed between the aorta and the SMA, leading to upper intestinal obstruction. This case report describes the clinical presentation, diagnostic process, and management of an eight-year-old girl with HSP complicated by SMA syndrome. The patient initially presented with abdominal pain and vomiting, eventually developing the characteristic rash of HSP. While initial management was supportive, her condition deteriorated. Treatment with intravenous methylprednisolone resulted in significant symptom improvement and resolution of both SMA syndrome and HSP manifestations. This case highlights the need to recognize SMA syndrome as a potential complication of HSP and demonstrates the effectiveness of steroid therapy in managing this condition. Further research is needed to develop comprehensive treatment guidelines for HSP patients with SMA syndrome.
过敏性紫癜（HSP）是一种系统性血管炎，其特征为可触及的紫癜、关节痛或关节炎、胃肠道症状以及肾脏受累。肠系膜上动脉（SMA）综合征是一种罕见疾病，当十二指肠第三部被主动脉和SMA压迫时发生，导致上消化道梗阻。本病例报告描述了一名患有并发SMA综合征的8岁女童的临床表现、诊断过程及治疗。患者最初表现为腹痛和呕吐，最终出现HSP的特征性皮疹。虽然初始治疗是支持性的，但她的病情恶化。静脉注射甲泼尼龙治疗使症状显著改善，SMA综合征和HSP表现均得到缓解。本病例强调了将SMA综合征识别为HSP潜在并发症的必要性，并证明了类固醇疗法在治疗该疾病中的有效性。需要进一步研究以制定针对患有SMA综合征的HSP患者的综合治疗指南。
