儿童过敏性紫癜合并可逆性后部脑白质综合征2例并文献复习

Children with Henoch-Schonlein purpura complicated with posterior reversible encephalopathy syndrome:2 cases report and literature review

可逆性后部脑白质病(PRES)是一种少见的急性神经系统疾病,病因复杂,具有可逆性,及时治疗可完全恢复,但其临床表现和影像学检查均缺乏特异性,易误诊漏诊,影响治疗及预后。过敏性紫癜(HSP)是儿童最常见的风湿免疫系统疾病,并发PRES的报道逐渐增多。为了提高儿科医师对儿童HSP合并PRES的认识,本文通过回顾性分析2例HSP合并PRES患儿的临床、影像学资料、治疗及预后转归,并结合文献复习,强调HSP患儿治疗过程中若出现惊厥、头痛、视觉障碍或意识障碍等临床表现时,需警惕合并PRES的可能,早期诊断和治疗HSP相关PRES,改善患儿预后。

Posterior reversible encephalopathy syndrome(PRES)is a rare acute neurological disease with complex etiology and reversibility.It can be completely recovered after timely treatment.However,its clinical manifestations and imaging examination are lack of specificity,which is easy to be misdiagnosed and missed,affecting treatment and prognosis.Henoch-Schonlein purpura(HSP)is the most common rheumatic immune system disease in children,and reports of PRES are increasing.In order to improve pediatricians′understanding of HSP complicated with PRES in children,this paper retrospectively analyzed the clinical and imaging data,treatment and prognosis of two children with HSP complicated with PRES,and combined with literature review,emphasized that if convulsion,headache,visual impairment or consciousness disturbance occurred during the treatment of HSP children.Attention should be paid to the possibility of concomitant PRES,and early diagnosis and treatment of HSP-related PRES should be made to improve the prognosis of children.