類過敏性紫斑病：2例報告

Henoch-schönlein Purpura Manifesting as Acute Abdomen in Pediatric Emergency--A Peport of 2 Cases

類過敏性紫斑（Anaphylactoid purpura, Henoch-Schönlein purpura），可見於各年齡層，但主要發生於孩提時期，是一種血管發炎性疾病（vasculitis syndrome）。我們提出2例報告：分別為4歲男孩與3歲女孩，呈現可觸摸性紫斑、腹部劇痛與膝關節疼痛，經類固醇治療後，臨床症狀急速好轉。第2例卻因好轉後，立刻停止類固醇給藥而復發，更合併上消化道出血；再給藥2個多星期後，病情受到控制，目前門診追蹤中。由於HSP是一種較良性的自限性疾病，對於類固醇的治療反應非常良好，因此診斷時的細心、確實，當可避免不必要的手術處理。我們更深深感觸，適當的類固醇投藥規劃是必要的，以免驟然停藥而導致病情復發。

Although Henoch-Schönlein Purpura (HSP) can occur at any age, it is mainly a disease of childhood, usually manifesting as vasculitis syndrome We report 2 cases of HSP affecting a 4-year-old boy and a 3-year-old girl respectively, with complaints of palpable purpura and refractory abdominal pain, that dramatically subsided with steroid treatment. However, after sudden discontinuation of steroid treatment, there was recurring colicky abdominal pain with upper gastrointestinal bleeding in the latter. Since most cases with HSP are clinically benign and self-limiting, they usually respond well to adequate steroid administration in cases of differential diagnosis of severe abdominal pain complicated by purpura and palpable skin induration. HSP should be kept in mind in order to avoid an unnecessary laparotomy. An adequate steroid administration regimen should be carried out, including dosage, duration, and tapering model according to the severity of clinical manifestation in every individual case, we suggested.