tailieunhanh - Báo cáo y học: " The clinical implications of adult-onset henoch-schonelin purpura"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: The clinical implications of adult-onset henoch-schonelin purpura. | Jithpratuck et al. Clinical and Molecular Allergy 2011 9 9 http content 9 1 9 REVIEW CMA CLINICAL AND MOLECULAR ALLERGY Open Access The clinical implications of adult-onset henoch-schonelin purpura 1 2 1 2 1 Warit Jithpratuck Yasmin Elshenawy Hana Saleh George Youngberg David S Chi and Guha Krishnaswamy Abstract Henoch-Schonlein Purpura HSP is a small vessel vasculitis mediated by IgA-immune complex deposition. It is characterized by the clinical tetrad of non-thrombocytopenic palpable purpura abdominal pain arthritis and renal involvement. Pathologically it can be considered a form of immune complex-mediated leukocytoclastic vasculitis LCV involving the skin and other organs. Though it primarily affects children over 90 of cases the occurrence in adults has been rarely reported. Management often involves the use of immunomodulatory or immune-suppressive regimens. Introduction Henoch-Schonlein Purpura HSP is a small vessel vasculitis mediated by IgA-immune complex deposition. It is characterized by the clinical tetrad of non-thrombocy-topenic palpable purpura abdominal pain arthritis and renal involvement 1 . Pathologically it can be considered a form of leukocytoclastic vasculitis that can involve not only the skin but other tissues as well. Though it primarily affects children over 90 of cases the occurrence in adults has been rarely reported to cases per million . This low incidence could be due to either under-diagnosis or misdiagnosis. Typically the disorder is commoner in males and may follow an infectious illness 2 . In the cases reported in children the majority of over 75 of cases presented with an eruption while up to 66 presented with abdominal pain and close to 50 the cases demonstrated renal involvement 2 . In children the disorder is often selflimiting while a more complicated course has been described in adults including a high incidence of renal insufficiency developing in almost 50 of those patients who