RESUMO
Henoch-Schönlein purpura (HSP) is the most common form of an immunological systemic vasculitis of childhood. The classic clinical symptoms include purpuric rash, abdominal pain, arthralgias, and haematuria, but the spectrum of HSP may vary to very rare forms. This article reports on an 8-year-old girl with a Henoch-Schönlein purpura (HSP) which resulted in an obstructive bladder mass and subsequent urinary retention. This is the first case reported in the literature, describing such a course.
Assuntos
Vasculite por IgA/complicações , Vasculite por IgA/diagnóstico , Doenças da Bexiga Urinária/diagnóstico , Doenças da Bexiga Urinária/etiologia , Obstrução do Colo da Bexiga Urinária/diagnóstico , Obstrução do Colo da Bexiga Urinária/etiologia , Retenção Urinária/diagnóstico , Retenção Urinária/etiologia , Biópsia , Criança , Cistite/diagnóstico , Cistite/etiologia , Cistite/patologia , Cistoscopia , Diagnóstico Diferencial , Feminino , Hematúria/diagnóstico , Hematúria/etiologia , Hematúria/patologia , Humanos , Vasculite por IgA/patologia , Bexiga Urinária/patologia , Doenças da Bexiga Urinária/patologia , Obstrução do Colo da Bexiga Urinária/patologia , Retenção Urinária/patologiaRESUMO
BACKGROUND: Alterations in thyroid function and structure have been reported in obesity. Function reverses to normal after weight loss, but nothing is known about structure. AIM: To evaluate the effect of weight loss on thyroid function and structure in obese children. SUBJECTS AND METHODS: The study was conducted in 72 overweight and obese children. Measurement of free T(3) (fT(3)), free T4 (fT(4)), TSH, antithyroid- antibodies and a thyroid ultrasound was performed at the beginning (phase 1) and after a period of 1.8±1.0 yr of lifestyle intervention (phase 2). RESULTS: Height SD score (SDS), body mass index SDS, total fat mass did not change from phase 1 to phase 2. Percentage of fat free mass decreased significantly (p<0.05). Waist/height ratio decreased (0.6±0.1 vs 0.5±0.1; p<0.05) as well as waist/hip ratio (0.9±0.1 vs 0.8±0.1; p<0.05). In phase 1, TSH was 2.8±1.7 mU/l; in phase 2, it was 2.2±0.9 mU/l (p<0.05); 17.2% of children showed a TSH level above the normal range (3.6 mU/l) in phase 1, and 6.2% in phase 2 (p<0.05). fT(4) was 10.8±2.2 pg/ml in phase 1 and 10.7±1.9 pg/ml in phase 2. fT(3) was 4.4±1.3 pg/ml (phase 1) and 3.9±1.1 pg/ml (phase 2) (p<0.05). Thyroid volume was -0.5±0.8 SDS (phase 1) and -0.5±1 SDS (phase 2). A non-significant improvement in thyroid structure was observed. CONCLUSIONS: In conclusion, healthier lifestyle improves body composition, thyroid function, and structure.