[一过性皮质性失明合并Henoch-Schönlein紫癜合并支气管扩张1例]。

Ryumachi. [Rheumatism] Pub Date : 2000-08-01
M Shinohara, H Ideura, S Yano, A Maezawa, Y Nojima, T Naruse
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引用次数: 0

摘要

一名19岁的女性自出生以来一直接受支气管扩张治疗。1995年10月诊断为Henoch-Schönlein紫癜(HSP)和HSP肾炎,结果如下:腿部可触及点疹、腹痛、关节痛和蛋白尿。开始口服强的松龙后,除蛋白尿外临床症状消失。然而,尽管静脉注射甲基强的松龙脉冲、各种免疫抑制药物和华法林治疗,肾病综合征仍在继续。1998年2月,她因肺炎住进我院。几天后,她的肺炎在抗生素治疗下有所好转,但她突然出现了短暂性皮质性失明和急性肾衰竭。初步诊断为高血压性脑病和与血管炎相关的脑水肿,并给予硝苯地平、Glycelo和大剂量免疫球蛋白治疗。治疗后,她的视力和肾功能都有所改善。她是一个罕见的病例,伴有短暂的皮质性失明,支气管扩张和HSP。
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[A case of transient cortical blindness complicated by Henoch-Schönlein purpura with bronchiectasis].

A 19-year-old woman had been treated for bronchiectasis since she was born. In October 1995, she was diagnosed as Henoch-Schönlein purpura (HSP) and HSP nephritis with the findings as follows; palpable petechial rash of legs, abdominal pain, arthralgias, and proteinuria. The administration of oral prednisolone was started, the clinical symptoms except for proteinuria was disappeared. However, nephrotic syndrome was continued despite the therapy of intravenous methylprednisolone pulse, various immunosuppressive drugs and warfarin. In February 1998, she was admitted to our hospital because of pneumonia. Several days later, her pneumonia improved on treatment with antibiotics, but she suddenly developed transient cortical blindness and acute renal failure. A provisional diagnosis of hypertensive encephalopathy and cerebral edema related to vasculitis was made, and she was treated with nifedipine, Glycelo, and high dose immunoglobulin. After the treatment, her vision and renal function had improved. She is a rare case associated with transient cortical blindness, bronchiectasis, and HSP.

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