肺炎黴漿菌引起之類過敏性紫斑症：病例報告

Mycoplasma Penumoniae Induced Henoch-Schönlein Purpura: A Case Report

Henoch-Schönlein purpura又稱為類過敏性紫斑症，是兒童最常見的血管炎。此疾病常以特殊的皮膚紫斑來表現且會影響許多器官，大部分的病人經症狀治療後痊癒，少數病人有腎衰竭等嚴重併發症。本文報告一位七歲女童，兩天前開始發現雙下肢有多型性可觸摸紅疹及踝、膝關節疼痛，因此來本院求診。實驗室檢查發現紅血球沉降速率升高，及肺炎黴漿菌抗體試驗指數於十天內從1:320上升至>1:1280，皮膚病理切片發現是蝕白血球細胞性血管炎。病患被診斷為類過敏性紫斑症。本篇文章的目的是提醒基層醫師對此疾病應有所警覺，因為此疾病在基層醫療上報導的發生率是常常被低估的。基層醫師應了解類過敏性紫斑症的臨床表現、適當的治療方式、和轉診時機，最重要的是，提供病人長期併發症的資訊。

Henoch-Schönlein purpura (HSP), also known as anaphylactoid purpura, is the most common cause of vasculitis in children. HSP can affect multiple organs and is associated with a characteristic skin rash. Most cases resolve with symptomatic treatment, but serious complications such renal failure can occur. We present the case of a 7-year-old girl a 2-day history of arthralgia in the knees and ankles and polymorphic palpable skin purpura over the lower extremities. Laboratory data revealed a rising erythrocyte sedimentation rate, and the Mycoplasma pneumoniae antibody titer rose from 1:320 to ＞1:1280 within 10 days. Pathology evaluation of a skin biopsy revealed leukocytoclastic vasculitis, and HSP was diagnosed. The purpose of this report is to remind primary care physicians to be aware of this disease, since its incidence is frequently underestimated in primary care settings. A general practitioner should be able to recognize the manifestations of HSP, understand when to treat and when to refer, and be able to provide information to families about long-term consequences of HSP.