급성 췌장염과 저혈량성 급성 신부전이 동반된 Henoch-Schönlein 자반증 1예
A Case of Henoch-Schönlein Purpura with Acute Pancreatitis and Hypovolemic Acute Renal Failure
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초록
저자들은 하지의 자반과 함께 발생한 복통, 혈변, 구토, 핍뇨 등을 주소로 내원한 7세 소아에서 급성 췌장염과 저혈량성 급성 신부전이 함께 동반된 Henoch- Schönlein 자반증으로 진단하고 치료한 증례를 경험하였기에 문헌고찰과 함께 보고한다. 급성 췌장염은 Henoch-Schönlein 자반증 환자에서 매우 드문 합병증이지만 불필요한 개복술을 피하기 위하여 급성 복증의 다른 원인들과 반드시 감별 진단해야 한다.
Abstract
Gastrointestinal involvement in Henoch-Schönlein purpura (HSP) is common. However, both acute pancreatitis and acute renal failure appear to be very rare complications of HSP. We describe a case of HSP with acute pancreatitis and hypovolemic acute renal failure in a 7-year-old girl who presented with a vasculitic purpuric rash involving the lower extremities, abdominal pain, hematochezia, vomiting, and oliguria. Laboratory findings showed increased serum levels of amylase, lipase, and creatinine. An abdominal CT scan revealed diffuse enlargement of the head and body of the pancreas. The patient was successfully managed with conservative treatment, including corticosteroids, and then her pancreatic enzymes and renal function returned to normal. Acute pancreatitis should be differentiated from other causes of acute abdomen in HSP to avoid unnecessary surgery.
참고문헌 (15)
- Tizard EJ, "Henoch-Schonlein purpura", Arch Dis Child, 80, pp.380~383 (1999)
- Choong CK, "Intra-abdominal manifestations of Henoch-Schönlein purpura", J Paediatr Child Health, 34, pp.405~409 (1998)
- Delclaux C, "Acute reversible renal failure with macroscopic haematuria in IgA nephropathy", Nephrol Dial Transplant, 8, pp.195~199 (1993)
- Kobayashi Y, "Acute reversible renal failure with macroscopic hematuria in Henoch-Schönlein purpura", Pediatr Nephrol, 16, pp.742~744 (2001)
- 이성철, "Allergic purpura에 합병된 acute pancreatitis 1례", 대한소아소화기영양학회지, 2, pp.116~122 (1999)
- Toskin KD, "Syndrome of hemorrhagic pancreatitis as a manifestation of Schonlein Henoch disease", Klin Khir, 11, pp.65~67 (1965)
- Garner JA, "Acute pancreatitis as a complication of anaphylactoid (Henoch-Schönlein) purpura", Arch Dis Child, 52, pp.971~972 (1977)
- Cheung KM, "Pancreatitis associated with Henoch-Schonlein purpura", J Paediatr Child Health, 37, pp.311~313 (2001)
- Branski D, "Pancreatitis as a complication of Henoch- Schönlein purpura", J Pediatr Gastroenterol Nutr, 1, pp.275~276 (1982)
- Soyer T, "Acute pancreatitis: a rare presenting feature of Henoch Schonlein purpura", J Paediatr Child Health, 44, pp.152~153 (2008)
- Wu CS, "Henoch-Schonlein purpura complicated by upper gastrointestinal bleeding with an unusual endoscopic picture", J Clin Gastroenterol, 19, pp.128~131 (1994)
- Lerner A, "Pancreatic diseases in children", Pediatr Clin North Am, 43, pp.125~156 (1996)
- Nydegger A, "Childhood pancreatitis", J Gastroenterol Hepatol, 21, pp.499~509 (2006)
- Lopez MJ, "The changing incidence of acute pancreatitis in children: a single-institution perspective", J Pediatr, 140, pp.622~624 (2002)
- Robson WL, "Henoch-Schönlein purpura", Adv Pediatr, 41, pp.163~194 (1994)