儿童紫癜性肾炎相关的可逆性后部脑白质综合征2例报告

Henoch-Schonlein purpura nephritis complicated by posterior reversible leukoencephalopathy syndrome:a report of two cases

目的探讨儿童紫癜性肾炎(HSPN)合并可逆性后部脑白质综合征(PRLS)的发病机制、诊断、治疗和预后。方法回顾分析2例HSPN合并PRLS患儿的临床资料,并复习相关文献。结果 2例患儿均为男性,分别为8岁、14岁。因水肿、蛋白尿明显,给予激素、免疫抑制剂、丙种球蛋白、血浆、白蛋白等治疗。病程中出现抽搐发作、意识丧失,头颅MRI显示额叶、顶叶、枕叶等部位多发异常信号,经止惊、降颅压等治疗,抽搐停止、意识恢复,MRI异常信号较前明显改善。结论在HSPN治疗过程中需警惕PRLS。

Objectives To explore the pathogenesis,diagnosis,treatment and prognosis of children with Henoch-Sch?nlein purpura nephritis(HSPN)complicated by posterior reversible leukoencephalopathy syndrome(PRLS).Method The clinical data of 2 children with HSPN complicated by PRLS were retrospectively analyzed,and the related literature was reviewed.Results Two boys aged 8 years and 14 years were given hormone,immunosuppressant,gamma globulin,plasma and albumin because of obvious edema and proteinuria.Seizures and loss of consciousness occurred during the course of the disease.MRI showed multiple abnormal signals in frontal lobe,parietal lobe and occipital lobe.The seizure stopped and consciousness recovered after treatment of controlling convulsion and decreasing intracranial pressure,and MRI abnormal signal was also significantly improved.Conclusion Clinicians should be vigilant about PRLS during the treatment of HSPN.