过敏性紫癜-邬惊雷.ppt

过敏性紫癜
Anaphylactoid Purpura
许兰-亨诺血管炎(综合征)
Schonlein-Henoch vasculitis(syndrome)

儿科医院邬惊雷
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 plexes 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!