[关注儿科IgA血管炎诊断和预后的最新进展]。

Ana Luisa Rodríguez-Lozano, Blanca Giovanna Delgado-Sánchez, Laura Berrón-Ruiz, Ruth Guadalupe Nájera-Velázquez, Chiharu Murata
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引用次数: 0

摘要

IgA血管炎是儿童时期最常见的血管炎,其主要特征是白细胞破坏性血管炎,毛细血管受到IgA免疫复合物沉积的影响。皮疹是主要的临床表现,同时伴有关节痛或关节炎,消化道和肾脏受累,通常是自限性的。虽然它发生在任何年龄,但它更倾向于3至12岁的儿童。确定一个触发因素是很常见的,最常见的是与感染有关,据报告,呼吸道感染的触发因素高达31%,其次是胃肠道感染,占5%。皮肤病表现是本病的特征性因素;100%的患者都有紫癜;然而,肾脏受累决定了这些患者的预后。诊断是临床诊断,由实验室和橱柜助手和分类标准支持;然而,由于预后主要取决于肾脏受累,有简单和安全的替代方案,充分的随访,治疗效果的评估以及疾病的预后是生物标志物的一些主要目标。初始治疗包括一般措施,但在胃肠道、肾脏或其他靶器官(如睾丸)受累的情况下,有必要使用皮质类固醇和免疫抑制剂治疗。自上世纪末以来,人们已经认识到并非所有IgA血管炎患者都有良性结局;然而,最近的数据支持肾炎患者和妊娠患者的有害结果。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Update on IgA vasculitis with a focus on diagnosis and prognosis in pediatrics].

IgA vasculitis is the most common vasculitis in childhood, and its main feature is leukocytoclastic vasculitis, in which the capillaries are affected by the deposit of IgA immune complexes. Skin rash is the principal clinical manifestation, along with arthralgia or arthritis, digestive and renal tract involvement, and is often self-limiting. Although it occurs at any age, it prefers children between 3 and 12 years. It is common to identify a trigger, the most frequently associated with infection, with reports of up to 31% along respiratory tract infections, followed by gastrointestinal infections at 5%. Dermatological manifestations are the characteristic element of the disease; 100% of patients have purpura at some point; however, renal involvement determines the prognosis of these patients. The diagnosis is clinical, supported by laboratory and cabinet assistants and classification criteria; however, since the prognosis is mainly conditioned by renal involvement, having simple and safe alternatives, adequate follow-up, evaluation of the efficacy of the treatment, and the prognosis of the disease are some of the main objectives of biomarkers. Initial treatment consists of general measures, but in the case of gastrointestinal, renal, or other target organ involvement, such as testicles, therapy with corticosteroids and immunosuppressants is necessary. Since the end of the last century, it has been recognized that not all patients with IgA vasculitis had a benign outcome; however, recent data supports a deleterious outcome both in patients with nephritis and in pregnancy.

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