Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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A Case of Henoch-Schonlein Purpura Nephritis Complicating Encephalopathy Accompanied by Hypertension and Cerebral Vasculitis

고혈압과 뇌혈관염이 동반된 상태에서 뇌증을 보인 Henoch-Schonlein Purpura Nephritis 1례

  • Choi, Hee Ra (Department of Pediatrics, College of Medicine, Gyeongsang National University) ;
  • Kim, Eo Jin (Department of Pediatrics, College of Medicine, Gyeongsang National University) ;
  • Choi, Myoung Bum (Department of Pediatrics, College of Medicine, Gyeongsang National University) ;
  • Lim, Jae Young (Department of Pediatrics, College of Medicine, Gyeongsang National University) ;
  • Park, Chan Hoo (Department of Pediatrics, College of Medicine, Gyeongsang National University) ;
  • Woo, Hyang Ok (Department of Pediatrics, College of Medicine, Gyeongsang National University) ;
  • Youn, Hee Sang (Department of Pediatrics, College of Medicine, Gyeongsang National University)
  • 최희라 (경상대학교 의과대학 소아과학교실) ;
  • 김어진 (경상대학교 의과대학 소아과학교실) ;
  • 최명범 (경상대학교 의과대학 소아과학교실) ;
  • 임재영 (경상대학교 의과대학 소아과학교실) ;
  • 박찬후 (경상대학교 의과대학 소아과학교실) ;
  • 우향옥 (경상대학교 의과대학 소아과학교실) ;
  • 윤희상 (경상대학교 의과대학 소아과학교실)
  • Received : 2003.05.28
  • Accepted : 2003.08.12
  • Published : 2003.10.15
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Abstract

Henoch-Shonlein purpura(HSP) is a systemic small-vessel vasculitis that primarily affects the skin, gastrointestinal tract, joints, and kidneys. The nervous system may be involved, less commonly than other organs. When the central nervous system(CNS) was involved, headache, changes in mental status, seizures, and focal neurologic deficits have been reported. Hypertension, uremic encephalopathy, metabolic abnomalities, electrolyte abnormalities, or cerebral vasculitis were suggested as possible causes of the neurologic manifestation. Diagnosis of vasculitic involvement of CNS is difficult. Magnetic resonance imaging of the brain is the modality of choice for the evaluation of the CNS disease. Steroid or plasmapheresis are used in treatment of cerebral vasculitis. We experienced a case of 9-year-old boy who had presented with Henoch-Schonlein purpura nephritis complicating encephalopathy accompanied by hypertension and cerebral vasculitis. Brain MRI showed multiple small nodular-linear pattern enhancing lesions in whole cerebral hemispheres and focal increased T2 signal in the right basal ganglia. We used intravenous immunoglobulin in treatment of cerebral vasculitis. We report this case with a brief review of related literature.

저자들은 9세 남아에서 고혈압과 뇌혈관염이 동반된 상태에서 뇌증을 보인 HSP 신염 1례를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

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