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Development of henoch-schoenlein purpura in a child with idiopathic hypereosinophilia syndrome with multiple thrombotic onset: A case report

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World Journal of Clinical Cases 2023年第4期11卷 952-961页

作者： Yan-Yan Xu Xiao-Bi Huang Yun-Gong Wang Li-Yun Zheng Min Li Yu Dai Sheng Zhao Department of Pediatric Cardiovascular Anhui Province Children's HospitalAnhui Hospital of Children's Hospital Affiliated with Fudan UniversityHefei 230051Anhui ProvinceChina Department of Pediatric Intensive Care Unit Anhui Province Children's HospitalAnhui Hospital of Children's Hospital affiliated with Fudan UniversityHefei 230051Anhui ProvinceChina Department of Pediatrics The Fourth Affiliated Hospital of Anhui Medical UniversityHefei 230032Anhui ProvinceChina

BACKGROUND The incidence of pulmonary embolism(PE) in children is low, but its mortality is high. Hypereosinophilic syndrome(HES) is a group of diseases caused by an abnormal increase in eosinophilic granulocytes resulting in multiple-organ dysfunction. The urgent event of thromboembolism in the pulmonary region provoked by eosinophils in idiopathic HES(IHES) is relatively unusual. This article reports a case of IHES with multiple PEs and left leg venous thrombosis as the first manifestation. One month later, the patient developed henoch-Schonlein purpura(HSP), which is very *** SUMMARY We report the case of a 12-year-old boy who was admitted to the hospital with dyspnea, left leg pain, and aggravation. He had bilateral PE and left leg venous embolism with mild eosinophilia. Low-molecular-weight heparin and urokinase were given. At the same time, the interventional department was contacted about filter implantation, followed by urokinase thrombolysis. The left leg thrombus was aspirated under ultrasound guidance. He was discharged from the hospital on rivaroxaban. One month later, he developed a rash on both legs and ankle pain consistent with HSP, with severe eosinophilia and motor and sensory disturbances. The patient was diagnosed with IHES with multiple embolisms complicated by HSP after excluding other causes of the eosinophil elevation. After glucocorticoid treatment, the symptoms were relieved, but the patient later developed purpura *** We report a rare and life-threatening case of IHES with multiple embolisms associated with HSP.A mild elevation of eosinophils early in the disease leads to difficulties in diagnosis and delayed treatment.

关键词： Eosinophil Hypereosinophilic syndrome henoch-schoenlein purpura Thrombosis Case report

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Immunoglobulin A vasculitis nephritis:Current understanding of pathogenesis and treatment

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World Journal of Nephrology 2023年第4期12卷 82-92页

作者： Michela Amatruda Nicolina Stefania Carucci Roberto Chimenz Giovanni Conti Pediatric Nephrology and Rheumatology Unit AOU G MartinoUniversity of MessinaMessina 98125Italy

The clinical spectrum of immunoglobulin A vasculitis nephritis(IgAVN)ranges from the relatively common transitory microscopic hematuria and/or low-grade proteinuria to nephritic or nephrotic syndrome,rapidly progressive glomerulonephritis,or even renal *** and experimental studies have shown a multifactor pathogenesis:Infection triggers,impaired glycosylation of IgA1,complement activation,Toll-like-receptor activation and B cell *** knowledge can identify IgAVN patients at a greater risk for adverse outcome and increase the evidence for treatment recommendations.

关键词： Immunoglobulin A vasculitis nephritis Immunoglobulin A vasculitis henoch-schoenlein purpura Immunoglobulin A nephropathy Vasculitis,glomerulonephritis

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