La Revue de médecine interne
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Review Case Reports
[Acute pancreatitis in rheumatoid purpura. Apropos of 2 cases].
Abdominal pain observed in Henoch-Schönlein purpura (HSP) is usually attributed to digestive tract involvement. Pancreatic involvement is a rare and benign complication. The authors report two cases of acute pancreatitis as a complication of HSP. ⋯ Abdominal pain can be explained by a digestive tract involvement but also by an acute pancreatitis. This later occurrence is not as exceptional as reported in the literature. Thus, serum amylase levels should be evaluated in patients with HSP who have intense epigastric or abdominal pain, in order to recognize a pancreatic involvement.
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To assess the accuracy of diagnostic strategy of pulmonary embolism (PE) based on clinical examination, lung scan and venous duplex US findings. ⋯ Pulmonary angiography seems theoretically necessary in less than 26% of the patients with suspected PE when they have undergone lung scan and venous duplex US. In this case, and when these strategies are not very decisive, it would be important to assess the diagnostic value of spiral CT scanning.
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Henoch-Schönlein purpura is a vasculitis usually with a benign course. Abdominal symptoms occur in 70% of cases, with possible intussusception or intestinal perforation. ⋯ Intravenous immunoglobulins have been efficient in some cases with recurrent abdominal symptoms or progressive renal lesions. We report the case of a 19-year-old patient with severe abdominal involvement and early renal manifestations of Henoch-Schönlein disease, rapid and sustained improvement was obtained by intravenous immunoglobulins given during 48 hours.