Rare Superior Mesenteric Artery Syndrome in an Eight-Year-Old Girl With Henoch-Schönlein Purpura: A Case Report.

IF 1 Q3 MEDICINE, GENERAL & INTERNAL Cureus Pub Date : 2024-09-14 eCollection Date: 2024-09-01 DOI:10.7759/cureus.69389
Yamen Shayah, Osama Almadhoun, Drew Pierce, John H Lillvis, Rabheh Abdul-Aziz
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Abstract

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.

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一名八岁女孩罕见的肠系膜上动脉综合征(Henoch-Schönlein Purpura):病例报告。
过敏性紫癜(HSP)是一种全身性血管炎,以可触及的紫癜、关节痛或关节炎、消化道症状和肾脏受累为特征。肠系膜上动脉(SMA)综合征是一种罕见病,当十二指肠的第三部分受压于主动脉和肠系膜上动脉之间时,会导致上肠梗阻。本病例报告描述了一名患有 HSP 并发 SMA 综合征的八岁女孩的临床表现、诊断过程和治疗方法。患者最初表现为腹痛和呕吐,最终出现了 HSP 的特征性皮疹。虽然最初的治疗是支持性的,但她的病情不断恶化。经静脉注射甲基强的松龙治疗后,症状明显改善,SMA 综合征和 HSP 表现均得到缓解。该病例强调了将 SMA 综合征视为 HSP 潜在并发症的必要性,并证明了类固醇疗法在控制该病症方面的有效性。需要进一步开展研究,为患有 SMA 综合征的 HSP 患者制定全面的治疗指南。
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