Polyangitis overlap syndrome: A fatal case combined with adult Henoch‐Schönlein purpura and polyarteritis nodosa
Polyangitis overlap syndrome: A fatal case combined with adult Henoch‐Schönlein purpura and polyarteritis nodosa
复制标题
多血管炎重叠综合征：成人过敏性紫癜和结节性多动脉炎合并死亡一例
DOI：
10.1046/j.1440-1827.2003.01515.x
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发表时间：
2003
影响因子：
2.2
通讯作者：
Toshimitsu Suzuki
中科院分区：
文献类型：
--
作者：
Kazuo Watanabe;H. Abe;Tomoko Mishima;G. Ogura;Toshimitsu Suzuki
过敏性紫癜（Henoch-Schönlein purpura，HSP）是一种以皮肤和其他内脏器官的系统性过敏性血管炎为特征的常见疾病。除非合并严重的肾小球疾病，否则预后良好。我们报告了一例独特的系统性血管炎合并HSP和结节性多动脉炎（PN）的致命病例，患者为一名56岁男性，在发病一个月后死于进行性肾衰竭。他主诉关节痛、双下肢紫癜、鼻出血和柏油样便，入院时发现急性肾衰竭。皮肤活检从紫癜病变表现出白细胞破碎性血管炎伊加沉积，HSP被认为是。然而，肾衰竭进展迅速，随后并发急性心肌梗死。尸检发现肾脏、心脏和肠系膜的PN型坏死性血管炎导致这些器官的急性多发性梗死。我们认为目前的病例是多血管炎重叠综合征。当HSP患者出现进行性急性肾功能衰竭时，应积极怀疑多血管炎重叠综合征，并立即开始适当的治疗。
Henoch‐Schönlein purpura (HSP) is a rather common disease characterized by systemic hypersensitivity vasculitis in the skin and other visceral organs. It has a favorable prognosis unless it is complicated by severe glomerular disease. We report a distinctive fatal case of systemic vasculitis combined with HSP and polyarteritis nodosa (PN) in a 56‐year‐old man who died of progressive renal failure one month after the onset of the disease. He complained of arthralgia, purpura of both lower extremities, nasal bleeding and tarry stool, and acute renal failure was noted at the time of admission to hospital. A skin biopsy from the purpura lesion exhibited leucocytoclastic vasculitis with IgA deposition, and HSP was considered. However, renal failure progressed rapidly and subsequently was complicated by acute myocardial infarction. Postmortem examination revealed PN type necrotizing vasculitis in the kidneys, heart and mesentery resulting in acute multiple infarctions of these organs. We think the current case was a polyangitis overlap syndrome. It is important to suspect the polyangitis overlap syndrome positively when progressive acute renal failure is seen in a patient with HSP and to begin appropriate therapy immediately.