以高血压脑病发病的儿童多发性大动脉炎一例并文献复习

Takayasu's Arteritis in Children with Hypertensive Encephalopathy as Initial Symptom: A Case Analysis and Review of Relevant Literatures

目的分析儿童多发性大动脉炎(takayasu arteritis,TA)的临床特征,提高临床对儿童TA的认识。方法对以高血压脑病发病的儿童TA 1例的临床资料进行回顾性分析并复习相关文献。结果本例因发热6 d,头痛、呕吐4 d,阵发性抽搐1 d,以颅内感染收入院。行头颅CT检查未见异常,后发现血压高、尿蛋白,疑似肾疾病及高血压脑病,后因听诊脐周有血管杂音,进一步行腹部彩色多普勒超声及数字减影血管造影检查明确诊断为TA。予醋酸泼尼松及小剂量双嘧达莫治疗后病情很快控制,随访半年无病情活动。结论 TA可侵犯机体多个器官系统,临床表现缺乏特异性,提高对本病的认识,尽早明确诊断并治疗,可改善患儿的预后。

Objective To analyze the clinical characteristics of Takayasu＆#39;s arteritis （TA） and to raise the clinical awareness of TA with hypertensive encephalopathy as initial symptom. Methods A retrospective study of one child with TA was performed, and the related literature was reviewed. Results This patient was admitted to hospital and diagnosed with in-tracranial infection for fever for 6 days, headache and vomitting for 4 days, paroxysmal convulsion for 1 day. The head CT scan did not show abnormal findings. Then hypertension and proteinuria were found in this patient. The signs were once con-sidered to be caused by suspected renal disease and hypertensive encephalopathy. This case was diagnosed as TA by thoracic and abdominal Doppler ultrasound after the vascular murmur around the navel was heard. The disease was soon controlled after medication of oral prednisone and low-dose dipyridamole and there was no disease activity after a 6-month follow-up. Conclu-sion TA in children can invade multiple organs and systems. The clinical manifestations are lack of speciality. We should improve the awareness of TA. Early diagnosis and treatment can improve the prognosis of the disease.