儿童过敏性紫癜合并可逆性后部脑白质综合征2例并文献复习

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摘要

可逆性后部脑白质病（PRES）是一种少见的急性神经系统疾病，病因复杂，具有可逆性，及时治疗可完全恢复，但其临床表现和影像学检查均缺乏特异性，易误诊漏诊，影响治疗及预后。过敏性紫癜（HSP）是儿童最常见的风湿免疫系统疾病，并发PRES 的报道逐渐增多。为了提高儿科医师对儿童HSP 合并PRES 的认识，本文通过回顾性分析2 例HSP 合并PRES 患儿的临床、影像学资料、治疗及预后转归，并结合文献复习，强调HSP 患儿治疗过程中若出现惊厥、头痛、视觉障碍或意识障碍等临床表现时，需警惕合并PRES 的可能，早期诊断和治疗HSP相关PRES，改善患儿预后。

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关键词 ：过敏性紫癜, 可逆性后部白质脑病综合征, 儿童, 癫痫发作临床特点, 影像学

Abstract：

Posterior reversible encephalopathy syndrome (PRES) is a rare acute neurological disease with complex etiology and reversibility. It can be completely recovered after timely treatment. However, its clinical manifestations and imaging examination are lack of specificity, which is easy to be misdiagnosed and missed, affecting treatment and prognosis. Henoch-Schonlein purpura (HSP) is the most common rheumatic immune system disease in children, and reports of PRES are increasing. In order to improve pediatricians' understanding of HSP complicated with PRES in children, this paper retrospectively analyzed the clinical and imaging data, treatment and prognosis of two children with HSP complicated with PRES, and combined with literature review, emphasized that if convulsion, headache, visual impairment or consciousness disturbance occurred during the treatment of HSP children. Attention should be paid to the possibility of concomitant PRES, and early diagnosis and treatment of HSP-related PRES should be made to improve the prognosis of children.

Key words： Henoch-Schonlein purpura;Posterior reversible encephalopathy syndrome;Children;Clinical characteristics of epilepsy Imaging

通讯作者: 唐玉英（1974-），女，山东德州人，硕士，主任医师，小儿风湿免疫科病区主任，研究方向：过敏性紫癜、幼年特发性关节炎、系统性红斑狼疮、免疫缺陷病、发热待查等儿童风湿免疫及肾脏类疾病和儿科常见病多发病的诊断及治疗。

作者简介: 邴丽娟（1984-），女，甘肃兰州人，硕士，研究方向：过敏性紫癜、幼年特发性关节炎、系统性红斑狼疮、免疫缺陷病、发热待查等儿童风湿免疫及肾脏类疾病的诊断及治疗。

引用本文:

邴丽娟；韩娜；唐玉英；郑东丽；穆善善；李倩倩. 儿童过敏性紫癜合并可逆性后部脑白质综合征2例并文献复习[J]. 中国当代医药, 2022, 29(18): 168-171转175.
BING Lijuan1 HAN Na2 TANG Yuying1▲ ZHENG Dongli1 MU Shanshan1 LI Qianqian1. Children with Henoch-Sch o nlein purpura complicated with posterior reversible encephalopathy syndrome: 2 cases report and literature review. 中国当代医药, 2022, 29(18): 168-171转175.

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https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2022/V29/I18/168

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