Kano K, Ozawa T, Kuwashima S, Ito S
Department of First Pediatrics, Dokkyo University School of Medicine, Tochigi, Japan.
Acta Paediatr Jpn. 1998 Apr;40(2):159-61. doi: 10.1111/j.1442-200x.1998.tb01903.x.
A case of Henoch-Schönlein purpura (HSP) characterized by several unusual complications is reported. A 10-year-old boy was hospitalized with acute abdomen and developed purpura on the lower extremities after 4 days of hospitalization. He had protein-losing enteropathy, diagnosed by an elevated fecal alpha-1-antitrypsin clearance. The colicky abdominal pain and protein-losing enteropathy subsided after methylprednisolone pulse therapy was administered. He had left hydronephrosis and gall-bladder abnormalities detected by ultrasonography, and purpura nephritis. However, after improvement of these abnormalities, he showed steroid-induced epidural lipomatosis, detected by magnetic resonance imaging, which resolved with steroid reduction. Ultrasonography and magnetic resonance imaging were useful for detecting these uncommon multisystemic involvements in HSP.
报告了一例伴有多种罕见并发症的过敏性紫癜(HSP)病例。一名10岁男孩因急腹症住院,住院4天后下肢出现紫癜。他患有蛋白丢失性肠病,通过粪便α1抗胰蛋白酶清除率升高得以诊断。甲基强的松龙脉冲治疗后,绞痛性腹痛和蛋白丢失性肠病缓解。超声检查发现他有左肾积水和胆囊异常,还有紫癜性肾炎。然而,这些异常情况改善后,磁共振成像检测到他出现了类固醇诱导的硬膜外脂肪增多症,随着类固醇减量该症状得以缓解。超声检查和磁共振成像对于检测HSP中这些罕见的多系统受累情况很有用。