过敏性紫癜合并抗磷脂综合征1例报告并文献复习

摘要

目的 探讨过敏性紫癜与抗磷脂综合征的关系.方法 通过对1例以间断皮疹、血尿、蛋白尿及上肢肿痛为主诉的患儿进行肾组织病理、抗磷脂抗体检查,随访观察治疗反应,并结合文献复习进行综合分析.结果 患儿临床表现为过敏性紫癜混合型,肾脏病理为紫癜性肾炎(Ⅳb型)；同时有右上肢静脉血栓形成,狼疮抗凝血因子、抗心磷脂抗体IgM及抗β2糖蛋白-I抗体IgM阳性,诊断为过敏性紫癜合并抗磷脂综合征.给予泼尼松口服、环磷酰胺冲击以及抗凝治疗,患儿临床症状好转,尿蛋白和抗磷脂抗体转阴.结论 过敏性紫癜可以合并抗磷脂综合征,临床上应引起高度重视.%Objective To explore the relationship of Henoch-Sch(o)nlein purpura (HSP) and antiphospholipid syndrome (APS). Methods One patient presenting with purpura, hematuria, proteinuria and right extremity pain was followed up. The information about kidney tissue pathology, antiphospholipid antibody test, and response to treatment was collected and analyzed. The literatures were reviewed. Results The patient clinically manifested Henoch-Sch(o)nlein purpura. The pathologic diagnosis was Henoch-Sch(o)nlein purpura nephritis (type Ivb). The vein thrombosis was formed in right upper extremity veins. The anticoagulant, anticardiolipin antibodies and anti β2 glycoprotein I antibodies were positive. The diagnosis was Henoch-Sch(o)nlein purpura combined with antiphospholipid syndrome. After given oral pred-nisone, cyclophosphamide, and anticoagulant therapy, clinical symptoms of the patient were improved. The urine protein and antiphospholipid antibody were negative. Conclusions Henoch-Sch(o)nlein purpura could be combined with antiphospholipid syndrome. More attention should be paid to it in clinic.