Related Experiment Videos
[Two children with suspected primary vasculitis of mesenteric vessels--a case report]
Insights
This study highlights early diagnosis of pediatric vasculitis affecting mesenteric vessels. Key indicators like elevated white blood cell counts and C-reactive protein aid in identifying this condition.
Area of Science:
- Pediatric Rheumatology
- Gastroenterology
- Vascular Biology
Background:
- Primary vasculitis of mesenteric vessels is rare in children.
- Diagnosis often relies on invasive procedures or advanced imaging.
- Early identification is crucial to prevent irreversible vascular damage.
Observation:
- Two children presented with abdominal pain and bloody stools.
- Laboratory findings included leukocytosis, elevated C-reactive protein (CRP), and hypoalbuminemia.
- Coagulation studies showed increased FDP-E, D-dimer, and von Willebrand factor, indicating endothelial activation.
Findings:
- Imaging revealed edematous thickening of intestinal walls, suggestive of vasculitis.
- Absence of systemic symptoms like rash, arthritis, or proteinuria, and negative autoantibodies pointed towards restricted vasculitis.
- Intravenous prednisolone treatment led to complete recovery within two weeks.
Implications:
- Leukocyte counts, CRP, von Willebrand factor, and coagulation/fibrinolysis studies are valuable early diagnostic markers.
- Combined with imaging, these markers can facilitate early diagnosis of pediatric mesenteric vasculitis.
- Prompt diagnosis and treatment can prevent severe vascular complications in affected children.
Abstract:
We reported 2 children with suspected primary vasculitis of mesenteric vessels. Both children were admitted to our hospital with the complaints of abdominal pain, bloody stool or diarrhea. Laboratory examination simultaneously revealed leukocytosis with dominant neutrophils, positive CRP, and hypoalbuminemia. Although prothrombin time and activated partial thromboplastin time were within normal limits, the increased levels of FDP-E, D-dimer, and von Willebrand factor activity were observed, which suggested the endothelial cell activation and the coagulation/fibrinolysis system activation. Abdominal echography and CT scanning demonstrated the edematous thickening of intestinal or colon walls probably due to the vasculitic permeability changes of mesenteric artery. During the disease courses, skin rash, bleeding tendency, arthritis and proteinuria were not observed, and no autoantibodies including anti-nuclear antibody, anti-DNA antibody, and myeloperoxidase-antineutrophil cytoplasmic antibody, were detected. Taken together, we suspected these children as restricted vasculitis of mesenteric vessels. Intravenous prednisolone was administrated, and the clinical and laboratory abnormalities recovered completely within 2 weeks. Thus, we suggested that the leukocyte counts, CRP, and the determination of von Willebrand factor and coagulation/fibrinolysis study accompanied with X-ray, echography, and CT scanning will be useful for the early diagnosis of vasculitis before the pathologic and irreversible vascular damage are demonstrated.