Stenosing ureteritis in Henoch-Schonlein purpura: Report of two cases
Stenosing ureteritis in Henoch-Schonlein purpura: Report of two cases
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DOI：
10.1111/ped.12471
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发表时间：
2015-04-01
影响因子：
1.4
通讯作者：
Iwata, Naoyuki
中科院分区：
文献类型：
--
作者：
Kasahara, Katsuaki;Uemura, Osamu;Iwata, Naoyuki
狭窄性输尿管炎（SU）是过敏性紫癜（HSP）的罕见并发症，通常表现为严重的症状。我们报告两例HSP患者表现为肉眼血尿，凝血，腹绞痛性疼痛，其次是下肢紫癜。早期超声提示肾积水、肾盆腔粘膜增厚、输尿管扩张（UD），提示HSP合并SU。早期SU经强尼松龙治疗后，肾功能、肾盆腔粘膜增厚、UD逐渐恢复正常，疼痛逐渐消失。从肉眼血尿开始对HSP患者进行常规超声检查有助于发现早期SU，并促进强的松龙的保守治疗。特别是由于非特异性症状，容易误诊为热休克性肾炎。文献综述中给出了SU的共同特点、治疗方法及预后。
Stenosing ureteritis (SU), a rare complication of Henoch-Schonlein purpura (HSP), typically presents with severe symptoms. We report the cases of two HSP patients presenting with gross hematuria, blood clotting, and colicky flank pain, followed by purpura on the lower extremities. Early-stage ultrasonography indicated hydronephrosis, thickened renal pelvic mucous membrane, and ureteral dilatation (UD), suggesting HSP complicated with SU. After early SU treatment with prednisolone, kidney function, thickened renal pelvic mucous membrane, and UD progressively normalized and the pain gradually disappeared. Regular ultrasonography of HSP patients from the onset of gross hematuria can be useful to detect early SU and facilitate conservative therapy with prednisolone. Diagnosis of SU can be easily missed by assuming HSP nephritis, particularly owing to the non-specific symptoms. Common characteristics as well as treatment methods and prognosis of SU are given in the literature review.