过敏性紫癜课件.pptxVIP

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;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??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 perfo