一名 19 岁女性的类固醇依赖性复发性 IgA 血管炎

HCA healthcare journal of medicine Pub Date : 2024-08-01 eCollection Date: 2024-01-01 DOI:10.36518/2689-0216.1660
Hannah Berrett, Shivangi Gohil, Rebecca Kurian, Patricia Neyman
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引用次数: 0

摘要

背景:免疫球蛋白 A(IgA)血管炎常见于儿童,通常可自行缓解。然而,当成人发病时,病情更可能严重且反复发作:本病例为一名反复发作的类固醇依赖型 IgA 血管炎的 19 岁女性患者。她在童年时曾有过长时间的 IgA 血管炎病史。她因蛋白尿和双下肢疼痛、可触及的紫癜性皮疹来我院就诊。她接受了大剂量静脉类固醇治疗。类固醇减量后,患者的疼痛性皮疹复发。几个月后,她又出现了类固醇引起的高血糖和蛋白尿:最近的研究表明,皮质类固醇对 IgA 血管炎的长期疗效影响有限,但节省类固醇的药物在治疗复发性类固醇依赖型 IgA 血管炎方面具有潜力。
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Steroid-Dependent Recurrent IgA Vasculitis in a 19-Year-Old Woman.

Background: Immunoglobulin A (IgA) vasculitis is common in children and typically resolves spontaneously. However, when presenting in adults, it is more likely to be severe and recurrent.

Case presentation: We present the case of a 19-year-old female patient with recurrent steroid-dependent IgA vasculitis. She had a history of a prolonged episode of IgA vasculitis in childhood. She presented to our hospital with proteinuria and a painful, palpable purpuric rash on her bilateral lower extremities. She was treated with high-dose intravenous steroids. When steroids were tapered, the patient had a recurrence of her painful rash. Over several months, she developed steroid-induced hyperglycemia and worsening proteinuria.

Conclusion: Recent studies have shown that corticosteroids have limited effect on long-term outcomes in IgA vasculitis, but steroid-sparing agents have potential for the treatment of recurrent steroid-dependent IgA vasculitis.

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