[Henoch-Schönlein紫癜合并迟发性坏死性肾小球肾炎1例报告]。

Reumatizam Pub Date : 2014-01-01
Joško Mitrović, Silva Pukšić, Ivica Horvatić, Vesna Sredoja Tišma, Stela Bulimbašić, Jadranka Morović-Vergles
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引用次数: 0

摘要

Henoch-Schönlein紫癜(HSP)是最常见的全身性血管炎在儿童,而它是罕见的成人。典型的临床表现包括可触及的紫癜,但无血小板减少和/或凝血功能障碍,关节炎/关节痛,腹痛和/或肾脏受累。在成人中,该病往往比儿童更严重,在最初症状出现后的几天至一个月内出现肾脏症状。在这篇文章中,我们报告了一位22岁的女性皮肤血管炎和关节痛患者,她在发病8周后出现肾脏疾病,尿检中出现血尿和蛋白尿。随后进行的肾活检显示局灶性坏死性肾小球肾炎伴IgA沉积。患者接受大剂量甲基强的松龙治疗,随后逐渐减量,导致疾病完全缓解。总之,HSP患者应仔细监测是否有全身性受累,因为严重的肾脏疾病甚至可在发病后两个月发生。
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[Henoch-Schönlein purpura with late-onset necrotising glomerulonephritis--a case report].

Henoch-Schönlein purpura (HSP) is the most common systemic vasculitis in children, while it is rare in adults. Typical clinical manifestations include palpable purpura without thrombocytopenia and/or coagulopathy, arthritis/arthralgia, abdominal pain, and/or renal involvement. In adulthood the disease tends to be more serious than in children, with renal manifestations developing over a period of several days to one month after initial symptoms. In this article we present a 22-year-old female patient with cutaneous vasculitis and arthralgia, in whom renal disease developed 8 weeks after disease onset with microscopic hematuria and proteinuria in urinalysis. Renal biopsy subsequently performed revealed focal necrotising glomerulonephritis with IgA deposits. The patient was treated with high dose methylprednisolone followed by gradual tapering, which induced complete remission of the disease. In conclusion, patients with HSP should be carefully monitored for systemic involvement, since serious renal disease can develop even as late as two months after disease onset.

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