过敏性紫癜课件.pptVIP

过 敏 性 紫 癜 Anaphylactoid Purpura 许兰-亨诺血管炎(综合征) Schonlein-Henoch vasculitis(syndrome) 概 貌 Outline是一种小血管炎A kind of vasculitis of small vessels以皮肤紫癜、关节痛、积液、腹痛、便血、血尿和蛋白尿为主要临床特征Characterized clinically by purpura, arthralgia ,articular effusion, abdominal pain, hemafecia, hematuria and proteinuria 学龄前和学龄期儿童多见More frequent in preschoolers and school age children男孩发病率高于女孩Boys are affected more frequently than girls估计人群总体发病率约为9/10万The overall incidence estimated to be 9/100,000 population 病 因 Etiology 病因不清楚，可能与下列因素有关:The etiology is unknown, maybe related with the follows: 食物过敏：海鲜、蛋、牛奶 Food allergy: sea food, eggs, milk 感染：细菌、病毒、寄生虫 Infection: bacteria, virus , parasites 病 因 Etiology 药物：抗生素、阿司匹林 Drugs: antibiotics, aspirin 其它：虫咬、预防接种 Others: insect bite , immunization 病理改变 Histopathological findings 白细胞碎裂性血管炎 Leukocytoclastic vasculitis IgA为主的免疫复合物沉积 Deposition of immune complexes of IgA(in the small vessels and glomeruli) 病理改变 Histopathological findings肾脏病变：微小、局灶、新月体形成等箭头所指处为新月体 临床表现 Clinical manifestations 常随上呼吸道感染后 Usaually follows an upper respiratory tract infection 可有低热、纳差、乏力 Low-grade fever, losing appetite and fatigue may occur 皮肤紫癜 Purpura 高出皮面，初期压之退色 Palpable purpura that initially blanch on pressure 反复出现，呈紫红色 Appear at intervals and evolve from red to purple 对称分布于腰以下 Occur symmetrically below the waist 尚可伴有血管神经性水肿 May have angioedema 1 岁半女孩患过敏性紫癜：注意：局限于半下身，明显的、边缘清楚分布的皮疹！ 5 岁男孩患过敏性紫癜：典型的臀部皮疹 5 岁男孩患过敏性紫癜:典型的皮疹和双踝关节肿胀 4 岁女孩患过敏性紫癜：下肢伸侧显著、部分融合的皮疹 8 岁半男孩患过敏性紫癜：皮肤出血几乎仅限于双足背和大足趾；关节轻度肿胀 消化道症状 Symptoms of gastrointestinal tract 间歇性腹痛，位于脐周或下腹部 Intermittent abdominal pain localized to periomphalic area and lower abdomen 呕吐、便血 Vomiting, hemafecia 可有肠套叠、肠梗阻和肠穿孔 Intussusception, obstruction and bower perforation may occur 关节症状 主要累