Journal of Developmental Medicine(Electronic Version)  2017, Vol. 5 Issue (3): 168-171 DOI: |
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| Five cases about Henoch-Schönlein purpura complicated with central nervous system injury in children and literatures review |
| CHEN Ru-yue, SHEN Yun-yan, CHEN Qing, FENG Ya-jun, ZHU Yun, LI Xiao-zhong
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| Department of Nephrology, Immunology and Rheumatism, Children’s Hospital of Soochow University, Jiangsu, Suzhou 215000, China |
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Abstract Objective To analyze the clinical data of five cases of Henoch-Sch?nlein purpura (HSP) complicated with central nervous system injury in children and to investigate the therapy and prognosis of HSP. Methods From February 2011 to October 2015, five cases of HSP with central nervous system injury were admitted to the Department of Nephrology, Immunology, Rheumatism and Neurology, Children's Hospital of Soochow University. The clinical manifestations, results of imaging tests, results of laboratory tests and treatment methods of 5 cases were recorded through retrospective analysis method and the prognosis of children were followed up. Results Four cases had gastrointestinal symptoms. One case complicated unconsciousness and other central nervous system symptoms on the basis of repeated gastrointestinal symptoms, but other four cases only suffered headache. Two cases showed abnormal imaging tests with high signal of long T1, long T2 and FLAIR of lateral ventricular posterior horn or white matter in the right parietal lobe. Cranial CT and MRI of other three cases didn't show obvious abnormity. Humoral immunity test showed increase of IgA and IgG in varying degrees. Cerebrospinal fluid routine of four cases demonstrated increased white blood cells and total cells count; cerebrospinal fluid immunoglobulin showed increase of IgA and IgG to varying degrees. One case did not receive glucocorticoid treatment. Three cases received glucocorticoid and symptomatic treatment; one case occurred central nervous system symptoms in the process of hormone decrement, then more glucocorticoid and gamma globulin were used and the prognosis of the case was good. Conclusions The clinical manifestations of HSP complicated with central nervous system injury in children are headache and mental change and so on. Some cases accompanied by gastrointestinal symptoms. Lesions of central nervous system often locate in the posterior part of the brain by imageological examination. After early positive treatment by glucocorticoid and symptomatic treatment, most cases can recover in short term with good prognosis, but the patients need long-term follow-up.
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Received: 06 April 2017
Published: 12 January 2018
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