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目的:讨论小儿过敏性紫癜(HSP)的病因、临床表现、治疗、预防、预后及早确诊,减少误诊。方法:对1998年1月1日~2006年8月30日42例过敏性紫癜患儿的一般资料、临床表现、实验室检查、治疗等进行系统性回顾性分析。结果:大多数患儿主要表现为反复出现的皮疹、腹痛、关节痛、尿检查异常,皮肤表现者误诊为肾炎2例,单纯性荨麻疹3例。以消化道为首发的误诊为胃肠痉挛3例,胃炎、肠炎各2例。肠系膜淋巴结炎、胰腺炎、胆道蛔虫各1例。以关节为首发症状者误诊为风湿性关节炎1例。结论:单纯皮肤紫癜诊断并不困难,而先于皮肤紫癜出现消化道症状、关节症状、皮肤血管神经水肿者极易导致误诊。大部分预后良好,部分可病情反复、迁延甚至肾功能损害。
Objective: To discuss the etiology, clinical manifestation, treatment, prevention and prognosis of children with Henoch-Schonlein purpura (HSP) and to reduce the misdiagnosis. Methods: The data, clinical manifestations, laboratory tests and treatments of 42 children with Henoch-Schonlein purpura from January 1, 1998 to August 30, 2006 were systematically analyzed retrospectively. Results: Most of the children showed recurrent skin rashes, abdominal pain, joint pain and abnormal urinalysis. 2 cases of nephritis and 3 cases of simple urticaria were misdiagnosed as skin manifestations. Digestive tract as the first misdiagnosed as gastrointestinal spasm in 3 cases, gastritis, enteritis in 2 cases. Mesenteric lymphadenitis, pancreatitis, biliary ascariasis in 1 case. One case of rheumatoid arthritis was misdiagnosed as the first symptom of joint. Conclusion: Pure skin purpura diagnosis is not difficult, but before the skin purpura gastrointestinal symptoms, joint symptoms, skin angioedema easily lead to misdiagnosis. Most of the prognosis is good, some may be repeated illness, delay and even renal dysfunction.