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[病例]女,10岁,因反复四肢皮疹3年入院。3年前无诱因四肢出现皮疹,以关节附近较多,呈对称性分布、大小不等,略高于皮肤的充血性皮疹。无关节肿痛,无腹痛,血小板正常。诊断为过敏性紫癜。3年来皮疹反复出现,用激素治疗皮疹消退。本次入院前10天四肢出现同样皮诊,无腹痛及关节肿痛,无肉眼血尿,无血便。病程中无发烧、浮肿及少尿,为进一步诊治入院。自幼发现有先天性心脏病,生长发育较正常儿略差。肢伸侧可见大小不等略高于皮肤表面呈对称性分布的丘疹,压之不裉色,以踝关节处多见。浅表淋巴结无肿大,双肺正常,心率96次/min,节律齐,心音有力,胸骨左缘2、3肋间可闻Ⅳ级收缩期杂音,肝脾未触及。4次尿常规检查,蛋白(-)—(+)、白细胞3～5/400×、红细胞满视野。其他实验室检查均正常。心脏B超检查提示房间隔缺损。
[Case] Female, 10 years old, admitted to hospital due to repeated extremities rash 3 years. 3 years ago, there is no incentive to appear rash on the limbs, the joints are more symmetrical distribution, size, slightly higher than the congestive skin rash. No joint swelling and pain, no abdominal pain, normal platelets. Diagnosis of allergic purpura. 3 years rash recurring, hormonal treatment rash subsided. The same 10 days before admission, the same appearance of limbs, no abdominal pain and joint swelling and pain, no gross hematuria, no bloody stools. No fever, edema and oliguria in the course of the disease for further diagnosis and treatment of admission. Found congenital heart disease since childhood, growth and development slightly worse than normal children. Limb extensor can be seen ranging in size slightly higher than the surface of the skin is symmetrical distribution of pimples, pressure is not color, to the ankle joint more common. Superficial lymph nodes without swelling, normal lungs, heart rate 96 beats / min, rhythm Qi, powerful heart sounds, the left border of the sternal 2,3 intercostal smell IV systolic murmur, liver and spleen not touched. 4 times urinary routine examination, protein (-) - (+), white blood cells 3 ~ 5/400 ×, full of red blood cells. Other laboratory tests are normal. Heart B-ultrasound atrial septal defect tips.