소뇌 및 위장관 출혈을 동반한 Henoch-Sch？nlein 자반증 1예 = A Case of Henoch-Sch？lein Purpura with Cerebellar and Gastrointestinal Bleeding

다국어 초록 (Multilingual Abstract)

Henoch-Schonlein purpura is a systemic leukocytoclastic vasculitis involving small vessels. The diagnostic criteria is defined as a typical skin rash of which pathologic examination shows leukocytoclastic vasculitis, accompanied by any two of these major manifestations of the disease, namely gastrointestinal tract, kidney, joint involvement. In elder patient, Henoch-Schonlein purpura shows more serious gastrointestinal tract involvement. There are some reports of brain involvement of Henoch-Schonlein purpura. A 69-year-old man was admitted to department of neurosurgery, because of loss of consciousness. Brain CT showed acute cerebellar hemorrhage with rapid resolution by conservative treatment. Diffuse purpuric eruptions on both low legs were developed after 7 days of hospitalization. He was refered to our department due to epigastric pain and bloody diarrhea. There were multiple longitudinal ulcers with hemorrhage on the stomach and the sigmoid colon of which biopsy showed leukocytoclastic vasculitis. Microscopic hematuria and proteinuria were also noted. He had a fatal course due to recurrent colonic bleeding and poor medical condition. We report an unusual case of cerebellar and gastrointestinal involvement of Henoch-Schonlein purpura in elderly patient.

국문 초록 (Abstract)

Henoch-Schönlein 자반증은 백혈구파쇄성 혈관염으로 주로 작은 혈관을 침범한다. 전신성 과민성 혈관염이므로 신체 어느 부위도 침범할 수 있으나 피부, 관절, 위장관 및 신장 등을 주로 침범하며 뇌혈관을 침범하는 경우는 드물다. 69세 남자 환자가 소뇌 출혈로 인한 의식장애로 신경외과에서 치료받던 중, 양측 하지에 미만성 피부 발진, 심와부 동통 및 혈성 설사를 주소로 소화기내과로 전과되었다. 이 환자는 특징적인 피부 병변과 미세혈뇨 및 단백뇨, 내시경적 조직검사에서 백혈구 파쇄성 혈관염의 소견을 보여 Henoch-Schönlein 자반증으로 진단할 수 있었다. 저자들은 드물게 소뇌 출혈이 선행되고 반복적인 위장관 출혈의 치명적인 경과를 취한 Henoch-Schönlein 자반증 1예를 경험하였기에 보고하는 바이다.

참고문헌 (Reference)

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