Çocukta Romatolojik Acil Bir Durum: Akut Bilinç Değişikliği ile Başvuran Bir Henoch Schönlein Vakası

Year 2010, Volume: 10 Issue: 3, 148 - 151, 01.07.2010

Müferet Ergüven Mehmet Malçok Öznur Yılmaz

https://doi.org/10.5222/j.child.2010.148

Abstract

Henoch Schönlein Vasküliti HSP artrit, artralji, karın ağrısı, gastrointestinal kanama ve glomerülonefrit ile karakterize çocukluk çağında en sık görülen lökositoklastik vaskülittir. Merkezi Sinir Sistemi MSS tutulumu ender görülen komplikasyonlarından birisidir. Ani bilinç kaybı, konvülziyon ile başvuran altı yaşındaki HSP’li kız hasta- mız, acil romatolojik bir vaka olması nedeniyle sunuldu. Yapılan görüntüleme yöntemleri ile HSP’nin MSS tutulu- munun geliştiği tespit edilen hasta, 3 ay önce HSP geçirmiş ve oluşan böbrek tutulumu nedeniyle steroid ve siklofosfa- mid tedavisi almıştı. Acilen 3 gün ardışık yüksek doz intra- venöz steroid tedavisi uygulanan hasta, yatışının ikinci haftasında şifa ile taburcu edildi

Keywords

Henoch Schönlein Vasküliti, Merkezi Sinir Sistemi Vaskuliti, nörolojik tutulum

A Rheumatological Emergency in a Child: Case of Henoch-Schönlein Purpura HSP Presenting with Sudden Loss of Consciousness

Abstract

Henoch Schönlein vasculitis HSV is the most common leukocytoclastic vasculitis of childhood characterized by arthritis, arthralgia, abdominal pain, gastrointestinal ble- eding and glomerulonephritis. Central nervous system CNS involvement is one of its rare complications.A six year- old girl with a diagnosis of HSP admitted with sud- den loss of consciousness, convulsions was presented, because of clinical rheumatologic emergency. CNS invol- vement was found in MRI of the patient who developed HSP three months ago and treated with steroid and cyclop- hosphamide because of renal involvement. Immediately sequential high-dose intravenous steroid therapy was app- lied for three days, and the patient was discharged within the second week of hospitalization

Keywords

Henoch Schönlein Vasculitis, Central Nervous System Vasculitis

References

• 1. Sandra T, Annalisa M, Francesca G, Massimo R, et al. Henoch-Schonlein purpura in childhood: Epidemiological and clinical analysis of 150 cases over a 5-year period and review of Literature. Semin Arthritis Rheum 2005; 35:143-53.
• 2. Chien-Liang Chen, Y.-H. Chiou, Chan-Yao Wu, PingHong Lai and Hsiao-Min Chung. Cerebral vasculitis in Henoch-Schönlein purpura: a case report with sequential magnetic resonance imaging changes and treated with plasmapheresis alone Pediatric Nephrology Volume 2000; 15:3-4.
• 3. Østergaard JR, Storm K. Neurologic manifestations of Schonlein–Henoch purpura. Acta Paediatr Scand 1991; 80:339-42.
• 4. Bulun A, Topaloglu R, Duzova A, Saatci I, Besbas N and Bakkaloglu A. Ataxia and peripheral neuropathy: rare manifestations in Henoch-Schönlein purpura Pediatric Nephrology 2001; 16:12.
• 5. Tae-Sun Ha and Sang-Hoon Cha. Cerebral vasculitis in Henoch-Schönlein purpura: a case report with sequential magnetic resonance imaging Pediatric Nephrology 1996; 10:5.
• 6. Yao-Ko Wen, Yu Yang and Chia-Chu Chang. Cerebral vasculitis and intracerebral hemorrhage in Henoch-Schönlein purpura treated with plasmapheresis Pediatric Nephrology 2005; 20:2.
• 7. Belman AL, Leicher CR, Moshe´ SL, Mezey AP. Neurologic manifestations of Schonlein–Henoch purpura: Report of three cases and review of the literature. Pediatrics 1985; 75:687- 92.
• 8. Palesse N, Marrelli A, Legge MP, and Gallucci M. Neurological complications of schoenlein-henoch syndrome: contribution of MR to the diagnosis. Case report The Italian Journal of Neurological Sciences 1989; 10:3.