Nhồi máu thận có thể là biểu hiện đầu tiên của bệnh Lupus ban đỏ hệ thống ở trẻ em=Renal infarction as an initial presentation of systemic Lupus erythematosus in children

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Tác giả: Thị Liễu Hà, Thành Công Mai, Thành Nam Nguyễn, Thị Thanh Nhàn Nguyễn, Thị Hồng Khánh Phạm, Hải Yến Tống

Ngôn ngữ: vie

Ký hiệu phân loại:

Thông tin xuất bản: Tạp chí Nghiên cứu y học (Đại học Y Hà Nội), 2024

Mô tả vật lý: tr.96-101

Bộ sưu tập: Metadata

ID: 244631

Thêm vào giỏ

Although systemic lupus erythematosus (SLE) has a high incidence of arterial and venous thrombosis, especially in patients with antiphospholipid antibodies (aPL), renal infarction is rarely reported and often misdiagnosed as other conditions. We report a case of a 15-year-old male child admitted to the hospital with abdominal pain, fever and arthritis. Computed tomography (CT) of the abdomen showed bilateral kidney infarction. Investigative tests performed confirmed that patient met the diagnostic criteria for SLE with positive antiphospholipid antibodies. The patient responded well when treated with anticoagulants, corticosteroids combined with hydroxychloroquine. Renal infarction can be the initial manifestation of systemic lupus erythematosus in children, requiring a comprehensive diagnostic approach to the causes of renal thrombosis for appropriate treatment.Mặc dù lupus ban đỏ hệ thống (SLE: systemic lupus erythematosus) có biểu hiện huyết khối động mạch và tĩnh mạch với tỉ lệ cao, đặc biệt là những bệnh nhân có kháng thể kháng phospholipid (antiphospholipid antibodies - aPL), tuy nhiên nhồi máu thận hiếm khi được báo cáo và thường bị chẩn đoán nhầm với các bệnh lý khác. Chúng tôi báo cáo một trường hợp trẻ nam, 15 tuổi nhập viện với biểu hiện đau bụng, sốt và viêm khớp. Chụp cắt lớp vi tính (CLVT) ổ bụng có hình ảnh nhồi máu thận hai bên. Các xét nghiệm tìm nguyên nhân nhồi máu thận cho thấy trẻ đáp ứng tiêu chuẩn chẩn đoán SLE với kháng thể kháng phospholipid dương tính. Tình trạng bệnh cải thiện tốt với điều trị thuốc chống đông, corticosteroid kết hợp với hydroxychloroquine. Nhồi máu thận có thể là biểu hiện ban đầu của lupus ban đỏ hệ thống ở trẻ em, cần tiếp cận chẩn đoán toàn diện các nguyên nhân gây huyết khối thận để điều trị phù hợp.

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