Henoch-Schönlein Vaskülitinde Şiddetli Gastrointestinal Tutulum: Vaka Sunumu

Year 2013, , 73 - 76, 01.04.2013

Belde Kasap Demir

https://doi.org/10.5222/j.child.2013.073

Abstract

Henoch-Schönlein purpurası HSP ile ilişkili gastrointes- tinal sistem bulguları karın ağrısından obstrüksiyona dek değişebilmektedir. Tedavide oral ya da intravenöz steroid kullanılabilmekte, yanıt alınamadığında puls metilpredni- zolon PMP , intravenöz immunglobulin ya da plazmaferez gibi tedavi seçeneklerine geçilebilmektedir. Altı yaşında erkek vaka bilateral alt ekstremitelerde palpabl purpura, bileklerde artrit, lomber ve frontal bölgelerde ağrılı yumu- şak doku ödemleri, skrotal ekimotik görünüm bulguları ile HSP tanısı aldı. İzleminde şiddetli karın ağrısı ve kanlı dışkılama yakınmaları gelişti. İki mg/kg dozunda başlanan steroid tedavisine yanıt alınamayarak PMP tedavisine geçildi. Tedavinin ilk dozunda epididimit gelişen ve üçüncü dozunda halen kanlı dışkılama izlenen vakada üçüncü doz- dan sonra yakınmalerde gerileme saptandı

Keywords

Henoch-Schönlein purpurası, gastrointestinal sistem, puls metilprednizolon

Severe Gastrointestinal Involvement in HenochSchoenlein Purpura: Case Report

Abstract

Henoch-Schönlein purpura HSP associated gastrointesti- nal symptoms vary from abdominal pain to obstruction. Oral/intravenous steroid is the treatment of choice. In case of failure, pulse methylprednisolone PMP , intravenous immunoglobulin, plasmapheresis may be needed. A six- year-old boy was diagnosed with HSP owing to palpable purpura, arthritis, painful soft tissue edema in lumbar and frontal areas, ecchymosis in scrotum. During the follow-up, he had severe abdominal pain and bloody stool, which did not respond to steroid therapy 2 mg/kg . PMP was institu- ted. Epididymitis developed after the first dose. and he had bloody stool while receiving the third dose, but remission in complaints was observed thereafter

Keywords

Henoch-Schoenlein purpura, gastrointestinal system, pulse methylprednisolone

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