Clinical and prognostic implications of gastrointestinal tract lesions in systemic vascular purpuras
- Authors: Mukhin NA1, Gulyaev SV1, Krivosheev ОG1, Semenkova ЕN1, Kogan EA1, Okhotnikova NL1, Zavodnov VY.1, Gmoshinsky IV1, Mazo VK1, Grane R1, Bjarnason I1
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Affiliations:
- Issue: Vol 78, No 2 (2003)
- Pages: 50-54
- Section: Editorial
- URL: https://ter-arkhiv.ru/0040-3660/article/view/29315
- ID: 29315
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Abstract
Material and methods. Incidence, clinical picture, complications of abdominal syndrome, its relations with principal extraintestinal manifestations of SVP were studied in 125 SVP patients. Absorption and barrier functions of the small intestine, their correlations with clinical activity of the disease were investigated in 32 SVP patients with no clinical signs of intestinal affection. Computer-assisted morphometry of duodenal mucosa biopsies was conducted and the results were compared to those of intestinal permiability and clinical activity of SVP.
Results. Negative correlation was found between the occurrence of abdominal syndrome and the patients' age. The gastrointestinal tract suffered more frequently in men. 21% patients had abdominal complications, association of abdominal syndrome with higher frequency of glomerulonephritis. In the absence of abdominal symptoms, the barrier function of the small intestine for protein macromolecules was impaired. This correlated with exacerbations of skin purpura. Increased intestinal permeability and activity of skin purpura correlated with severity of inflammation in the duodenal mucosa. Conclusion. Abdominal syndrome in SVP is an unfavourable prognostic factor indicating possible severe complications and high risk of glomerulonephritis. Subclinical intestinal involvement presenting as barrier dysfunction may contribute to aggravation of skin vasculitis.
About the authors
N A Mukhin
S V Gulyaev
О G Krivosheev
Е N Semenkova
E A Kogan
N L Okhotnikova
V Ya Zavodnov
I V Gmoshinsky
V K Mazo
R Grane
I Bjarnason
References
- Feldt R. Н., Srrickler G. В. The gastrointestinal manifestations of anaphylactoid purpura in children. Phoc. Mayo Clin. 1962: 37(18): 465-473.
- Kakit Y., Nohara K. Renal involvement in Henoch-Schonlein purpura: A multivariate analysis of prognostic factors. Kidney Int. 1998; 53: 1755-1759.
- Dalens В., Travade P., Labbe A., Bezou M. J. Diagnostic and prognostic value of fibrin stabilising factor in Schonlein-Henoch syndrome. Arch. Dis. Child. 1983; 58: 12-14.
- Wedgewood R. J., Klaus M. H. Anaphylactoid purpura (Schonlein-Henoch syndrome): A long-term follow-up study with special reference to renal involvement. Pediatrics 1955; 16: 343-348.
- Tancrede-Bohin E., Ochonisky S. Schonlein-Henoch purpura in adult patients: predictive factors for IgA glomerulonephritis in a retrospective study of 57 cases. Arch. Dermatol. 1997; 133: 438-442.
- Кривошеее О. Г. Системные сосудистые пурпуры - клиникоэтиологические варианты: Дис. ... канд. мед. наук. М.; 1999.
- Frank E. Die harmorrhagischen Diathesen. In: Schittenhelm, Handbuch der Krankheiten des Blutes tind der blutbildenden Organe 1925; Bd 2.