Acute hemorrhagic edema of childhood Suehiro, Ricardo M; Soares, Bianca S; Eisencraft, Adriana P ...
Turkish journal of pediatrics,
04/2007, Letnik:
49, Številka:
2
Journal Article
Recenzirano
Acute hemorrhagic edema (AHE) of childhood, a variant of Henoch-Schönlein purpura (HSP), is a rare vasculitis with benign course, generally no systemic involvement and rare flares. From January 1983 ...to June 2004, 4,502 patients were followed at the Pediatric Rheumatology Unit, Hospital of Clinics. Diagnosis of HSP was made in 203 cases (4.5%), of which 5 (0.1%) had AHE. All patients with AHE were male and the mean age at onset was 18 months (range: 8 to 21 months). All five cases presented vasculitis with characteristic hemorrhagic and purpuric lesions in malar region of the face, associated with painless edema of the hands and feet. Laboratory exams were normal. Upper respiratory tract infection preceding clinical manifestations occurred in four and mononucleosis in one. Treatment with corticosteroids was necessary only in one patient with necrotic lesions on the face and ears.
O presente trabalho tem como objetivo descrever aspectos da sexualidade, gravidez e pós-parto de três adolescentes com artrite idiopática juvenil (AIJ). No período entre 1983 e 2004, 4.638 pacientes ...foram acompanhados na Unidade de Reumatologia Pediátrica do Departamento de Pediatria da FMUSP, entre os quais 537 (11,5%) apresentaram o diagnóstico de AIJ (critérios do ILAR). Entre os pacientes com AIJ, três engravidaram durante o seguimento ambulatorial. A idade da primeira atividade sexual variou de 16 a 18 anos. A paciente 1 apresentou uma gestação gemelar a termo, permanecendo em atividade da doença durante toda a gravidez, em uso de 15mg/dia de prednisona. As pacientes 2 e 3 encontravam-se em remissão da doença, sem uso de medicamentos, apresentando gestação a termo sem intercorrências. A paciente 2, porém, evoluiu com recidiva da doença um ano após o parto. Todos os recém-nascidos foram adequados para idade gestacional e evoluíram adequadamente no período neonatal. Apenas a paciente 1 necessitou de prednisona, naproxeno e cloroquina na amamentação. O aumento da gravidez na adolescência é uma realidade nos serviços de reumatologia pediátrica, o que impõe novos debates sobre os aspectos da sexualidade e contracepção nessa população.The objective of the present study is to describe the sexuality aspects, pregnancy and postpartum in three adolescents with juvenile idiopathic arthritis (JIA). From 1983 to 2004, 4,638 patients were followed at the Pediatric Rheumatology Unit of the Pediatric Department of FMUSP, of which 537 (11.5%) were diagnosed with JIA (ILAR criteria) and three of these patients became pregnant during the follow-up period. The age at their first sexual intercourse ranged from 16 to 18 years old. Patient 1 presented a twin pregnancy, with active disease throughout pregnancy, and was on 15 mg of prednisone per day. Patients 2 and 3 were at disease remission, with no drug treatment, and had full-term pregnancies free of complications; patient 2, however, had a disease flare-up one year after the delivery. All newborns were adequate for gestational age and developed no complications during the neonatal period. Only patient 1 required prednisone, naproxen e chloroquine during breast-feeding. The increased frequency of pregnancy in adolescents is a reality in pediatric rheumatology centers, and it shows the importance of more debate concerning sexuality aspects and contraception in this population.
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