Clinical characteristics in children patients with allergic purpura with gastrointestinal tract symptoms as initial manifestation
10.3969/j.issn.1671-8348.2024.15.015
- VernacularTitle:以消化道症状为首发表现的HSP患儿的临床特点
- Author:
Chen CHEN
1
;
Yuan GAO
;
Yuxia ZHAO
;
Dan LUO
;
Qiong CHEN
;
Zhi YU
Author Information
1. 华中科技大学同济医学院附属武汉儿童医院消化内科,武汉 430010
- Keywords:
Henoch-Schonlein purpura;
endoscopy;
pathology;
mucosa;
immunofluorescence IgA
- From:
Chongqing Medicine
2024;53(15):2330-2333,2338
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical manifestations,endoscopic,histopathological and im-munofluorescence IgA detection characteristics in children patients with Henoch-Schonlein purpura (HSP) with gastrointestinal tract symptoms as initial symptoms.Methods The clinical data of 29 children admitted to this hospital from April 2018 to December 2019 with gastrointestinal symptoms as the first manifestation and initially diagnosed with HSP were retrospectively analyzed.The clinical manifestations,laboratory and imageological examination results,endoscopic and histopatological examination results,immunofluoresence IgA detection results,treatment regimen and outcome were analyzed.Results The clinical manifestations were mainly abdominal pain,vomiting,hematochezia,rash,joint swelling and pain,testicular swelling pain,etc.Hemoglobin was decreased (<110 g/L) in 3 cases (10.34%),the eosinophilic cells count was increased (>0.6×109/L) in 1 case and serum total IgE was increased in 8 cases (27.58%).The food specificity IgE was positive in 4 cases (13.79%),including crab,nut,soybean and mugwort 1 case each (3.45%).Twenty-two cases conducted the abdominal imageological examination,in which there were 5 cases of abdominal cavity hydrops,4 cases (13.79%) of pelvic cavity hydrops and 15 cases of intestinal wall edema and thickness.The endoscopic manifestations were mucosal hyperemia and edema in 29 cases (100.00%),erosion in 24 cases (82.76%),mucosal roughness in 10 cases (34.48%),ulceration in 8 cases (27.59%),and punctated bleeding in 6 cases.The main manifestations of mucosal pathology were mucosal inflammation with IgA deposition in 10 cases (34.48%).Immunofluorescence IgA detection was positive in 10 cases (34.48%).Conclusion When abdominal HSP is highly suspected,the endoscopic examination could be performed as soon as possible to evaluate the degree of mucosal lesions and perfect the immunofluorescence IgA detection to further identify the disease cause
