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題 名 | Gastrointestinal Manifestation and Outcome of Henoch-Schonlein Purpura in Children=兒童類過敏性紫斑症的胃腸表徵與其臨床結果 |
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作 者 | 趙舜卿; 江文山; 林思偕; 黃璟隆; | 書刊名 | 長庚醫學 |
卷 期 | 23:3 2000.03[民89.03] |
頁 次 | 頁135-141 |
分類號 | 417.5637 |
關鍵詞 | 類過敏性紫斑症; 腸胃表徵; 臨床預後; Henoch-schonlein purpura; Gastrointestinal manifestation; Outcome; |
語 文 | 英文(English) |
英文摘要 | Background. We reviewed the clinical and laboratory manifestations and analyzed the outcome in children with Henoch-Sch�nlein purpura (HSP) and gastrointestinal involvement. Methods. The medical records of 158 children who had Henoch-Sch lein purpura with gastrointestinal (GI) involvement admitted to our institution from June 1987 to December 1998 were reviewed. We retrospectively analyzed their demographic features, clinical manifestations, and outcome. Results. Totally 104 boys and 54 girls (male: female = 1.9:1) were enrolled in this study, with a mean age of diagnosis of 5.8±4.8 years (range: 2 to 13 years). Sixty- three (40%) of our patients had preceding upper respiratory tract infection. The main GI manifestations included abdominal pain (88%); GI bleeding (75%), and vomiting (25%). Bowel edema was found in 71% of examined patients. Upper GI endoscopy provided supportive evidence of HSP in 58% of patients examined. Five patients were found to have marked jejunal edema with bowel collapse leading to severe intestinal obstruction. Thirteen patients (8.2%) had emergent complications including massive blood loss from GI tract in 4, seizure in 2, severe hypoalbuminemia in 2, and emergent surgical condition in 6. Twenty-one patients (13%) experienced prolonged hospitalization (O10 days). Bilious vomiting, hematemesis, leukocytosis (>20000/cmm), high C-reactive protein (>50 mg/l), and hemorrhagic erosive duodenitis were found to correlate with prolonged hospitalization. Fourteen (20%) of 70 patients who received follow-up for more than 5 years experienced GI recurrence of HSP. Conclusion. Despite severe and protracted GI symptoms in some HSP patients, the overall prognosis of GI involvement in children with HSP remains good. |
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