{"created":"2024-03-07T05:37:05.778335+00:00","id":2000092,"links":{},"metadata":{"_buckets":{"deposit":"e501deb9-5a5d-4a17-8b8d-366e395ff5e3"},"_deposit":{"created_by":4,"id":"2000092","owner":"4","owners":[4],"pid":{"revision_id":0,"type":"depid","value":"2000092"},"status":"published"},"_oai":{"id":"oai:hama-med.repo.nii.ac.jp:02000092","sets":["1:75:1709274151436"]},"author_link":[],"control_number":"2000092","item_3_biblio_info_5":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2024-03-15","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1","bibliographicPageEnd":"45","bibliographicPageStart":"41","bibliographicVolumeNumber":"4","bibliographic_titles":[{"bibliographic_title":"浜松医科大学小児科学雑誌","bibliographic_titleLang":"ja"},{"bibliographic_title":"Hamamatsu Journal of Pediatrics","bibliographic_titleLang":"en"}]}]},"item_3_description_9":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"IgA血管炎（IgA vasculitis : IgAV）は自然軽快を期待できる良性疾患とされるが，紫斑病性腎炎（Henoch-Schönlein purpura nephritis : HSPN）合併の有無が患児の予後を左右する．血尿・蛋白尿が持続する場合には腎生検が行われ，組織学的重症度に応じて治療方針が決定される．多くのHSPN症例は免疫抑制治療により改善が見込まれるが，難治例の治療法は確立されていない．今回我々は，ステロイドパルス療法と多剤併用療法のみでは病勢を抑制できなかった反復性IgAVおよびHSPNの4歳女児に対し，扁桃摘出術・アデノイド切除術を施行後に再度ステロイドパルス療法と多剤併用療法を行った．その後はIgAVの再燃なく，尿所見も改善してゆき，約2年後に多剤併用療法を終了とした．難治性のIgAV/HSPNに対して，扁桃摘出術およびステロイドパルス療法は有効と考える．","subitem_description_language":"ja","subitem_description_type":"Abstract"},{"subitem_description":"Although IgA vasculitis (IgAV) is considered to be a self-limited benign disease, its prognosis depends on the presence of a renal complication known as Henoch-Schönlein purpura nephritis (HSPN). When hematuria and/or proteinuria persists in HSPN patients, a kidney biopsy is performed and treatment content is determined by the pathological severity. Although most HSPN cases are expected to improve with immunosuppressive treatment, no treatment has been established for refractory HSPN cases. In this report, we present a 4-year-old girl with recurrent IgAV and HSPN that could not be controlled with methylprednisolone pulse therapy and multidrug combination therapy. She underwent tonsillectomy and adenoidectomy, followed by methylprednisolone pulse therapy and multidrug therapy. Thereafter, there was no recurrence of her IgAV, her urinary findings improved, and multidrug therapy was terminated 2 years later. We suggest that the combination of tonsillectomy and methylprednisolone pulse therapy may be effective for refractory IgAV/HSPN.","subitem_description_language":"en","subitem_description_type":"Abstract"}]},"item_3_publisher_6":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"浜松医科大学小児科学雑誌編集部","subitem_publisher_language":"ja"}]},"item_3_relation_27":{"attribute_name":"医中誌論文ID","attribute_value_mlt":[{"subitem_relation_type":"isIdenticalTo","subitem_relation_type_id":{"subitem_relation_type_id_text":"2024288595","subitem_relation_type_select":"ICHUSHI"}}]},"item_3_source_id_20":{"attribute_name":"EISSN","attribute_value_mlt":[{"subitem_source_identifier":"2436-2433","subitem_source_identifier_type":"EISSN"}]},"item_3_version_type_32":{"attribute_name":"著者版フラグ","attribute_value_mlt":[{"subitem_version_resource":"http://purl.org/coar/version/c_970fb48d4fbd8a85","subitem_version_type":"VoR"}]},"item_access_right":{"attribute_name":"アクセス権","attribute_value_mlt":[{"subitem_access_right":"open access","subitem_access_right_uri":"http://purl.org/coar/access_right/c_abf2"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"北形, 綾一","creatorNameLang":"ja"},{"creatorName":"KITAGATA, Ryoichi","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"内田, 博之","creatorNameLang":"ja"},{"creatorName":"UCHIDA, Hiroshi","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"内山, 弘基","creatorNameLang":"ja"},{"creatorName":"UCHIYAMA, Hiroki","creatorNameLang":"en"}]},{"creatorNames":[{"creatorName":"石川, 貴充","creatorNameLang":"ja"},{"creatorName":"ISHIKAWA, Takamichi","creatorNameLang":"en"}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_access","date":[{"dateType":"Available","dateValue":"2024-03-15"}],"displaytype":"detail","filename":"hjop_4_1_41.pdf","filesize":[{"value":"611 KB"}],"format":"application/pdf","mimetype":"application/pdf","url":{"objectType":"fulltext","url":"https://hama-med.repo.nii.ac.jp/record/2000092/files/hjop_4_1_41.pdf"},"version_id":"d46c0482-6e02-48bd-a4e6-f988b8a7012a"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"IgA血管炎","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"紫斑病性腎炎","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"IgA血管炎関連腎炎","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"扁桃摘出術","subitem_subject_language":"ja","subitem_subject_scheme":"Other"},{"subitem_subject":"メチルプレドニゾロンパルス療法","subitem_subject_language":"ja","subitem_subject_scheme":"Other"}]},"item_language":{"attribute_name":"言語","attribute_value_mlt":[{"subitem_language":"jpn"}]},"item_resource_type":{"attribute_name":"資源タイプ","attribute_value_mlt":[{"resourcetype":"journal article","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"扁摘パルス療法が有効であった反復性IgA血管炎および紫斑病性腎炎の一例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"扁摘パルス療法が有効であった反復性IgA血管炎および紫斑病性腎炎の一例","subitem_title_language":"ja"},{"subitem_title":"A case of recurrent IgA vasculitis and nephritis treated effectively with tonsillectomy and methylprednisolone pulse therapy","subitem_title_language":"en"}]},"item_type_id":"3","owner":"4","path":["1709274151436"],"pubdate":{"attribute_name":"PubDate","attribute_value":"2024-03-15"},"publish_date":"2024-03-15","publish_status":"0","recid":"2000092","relation_version_is_last":true,"title":["扁摘パルス療法が有効であった反復性IgA血管炎および紫斑病性腎炎の一例"],"weko_creator_id":"4","weko_shared_id":-1},"updated":"2025-03-05T07:56:16.160110+00:00"}