{"created":"2023-06-19T08:45:50.005539+00:00","id":1223,"links":{},"metadata":{"_buckets":{"deposit":"35393d41-bc47-4110-90c5-c0874a4bc3ca"},"_deposit":{"created_by":25,"id":"1223","owners":[25],"pid":{"revision_id":0,"type":"depid","value":"1223"},"status":"published"},"_oai":{"id":"oai:ycu.repo.nii.ac.jp:00001223","sets":["4:71:328:329"]},"author_link":["2635","2636","2637","2638"],"item_10002_biblio_info_7":{"attribute_name":"書誌情報","attribute_value_mlt":[{"bibliographicIssueDates":{"bibliographicIssueDate":"2017-05-30","bibliographicIssueDateType":"Issued"},"bibliographicIssueNumber":"1・2","bibliographicPageEnd":"34","bibliographicPageStart":"29","bibliographicVolumeNumber":"68","bibliographic_titles":[{"bibliographic_title":"横浜医学"},{"bibliographic_title":"Yokohama Medical Journal","bibliographic_titleLang":"en"}]}]},"item_10002_description_5":{"attribute_name":"抄録","attribute_value_mlt":[{"subitem_description":"IgA血管炎は，小児に好発する血管炎で川崎病に次いで多く，紫斑，腹痛，関節痛，糸球体腎炎を特徴とし，自然治癒が多く重症例は少ない．私たちはステロイド薬で症状は改善したが，ステロイド薬の減量中に突然の消化管出血を来たしショックに陥った一男児例を経験した．\n8 歳男児．紫斑と腹痛で来院し，IgA血管炎の診断で入院加療となった．ステロイド薬で症状は改善したが，ステロイド薬の漸減中に突然の腹痛，大量の血性下痢，顔色不良，末梢冷感，頻脈，さらに紫斑の再燃を認めた．腹部超音波検査と腹部造影CT検査で小腸から上行結腸にかけての腸管壁の肥厚と腹水の貯留を認めたが，出血源の特定は困難だった．ショックに大量輸液，濃厚赤血球輸血を速やかに行い循環動態は安定した．血管炎にステロイド薬の増量と第XIII因子の投与を行い，翌日以降の再出血はなかった．血液濃縮所見と腸管の浮腫や腹水より，ショックの原因は血管炎に伴う消化管出血と血管透過性亢進による血管内脱水の双方が推定された．消化器症状の改善とともに腹部超音波検査所見も改善した．\nショックに至る例は成人を含め報告例は少ないが，本症例と同様にステロイド薬で症状が軽快した後にショック状態を呈した例がみられた．\nIgA血管炎は，ステロイド薬の減量中に消化管出血をきたすことがあり，身体所見，血液検査所見だけでなく，腹部超音波検査所見を定期的に観察することが重要であろう．","subitem_description_type":"Abstract"}]},"item_10002_publisher_8":{"attribute_name":"出版者","attribute_value_mlt":[{"subitem_publisher":"横浜市立大学医学会"}]},"item_10002_source_id_9":{"attribute_name":"ISSN","attribute_value_mlt":[{"subitem_source_identifier":"0372-7726","subitem_source_identifier_type":"ISSN"}]},"item_creator":{"attribute_name":"著者","attribute_type":"creator","attribute_value_mlt":[{"creatorNames":[{"creatorName":"土田, 哲也"},{"creatorName":"ツチダ, テツヤ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"福島, 亮介"},{"creatorName":"フクシマ, リョウスケ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"金子　, 尚樹"},{"creatorName":"カネコ, ナオキ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]},{"creatorNames":[{"creatorName":"伊藤, 秀一"},{"creatorName":"イトウ, シュウイチ","creatorNameLang":"ja-Kana"}],"nameIdentifiers":[{}]}]},"item_files":{"attribute_name":"ファイル情報","attribute_type":"file","attribute_value_mlt":[{"accessrole":"open_date","date":[{"dateType":"Available","dateValue":"2017-08-08"}],"displaytype":"detail","filename":"06_Tsuchida.pdf","filesize":[{"value":"837.0 kB"}],"format":"application/pdf","licensetype":"license_11","mimetype":"application/pdf","url":{"label":"横浜医学68巻1・2号","url":"https://ycu.repo.nii.ac.jp/record/1223/files/06_Tsuchida.pdf"},"version_id":"ac536f3f-cfa0-4059-8eff-64c14c461e07"}]},"item_keyword":{"attribute_name":"キーワード","attribute_value_mlt":[{"subitem_subject":"IgA血管炎","subitem_subject_scheme":"Other"},{"subitem_subject":"循環血液量減少性ショック","subitem_subject_scheme":"Other"},{"subitem_subject":"消化管出血","subitem_subject_scheme":"Other"},{"subitem_subject":"腹部超音波検査","subitem_subject_scheme":"Other"},{"subitem_subject":"IgA vasculitis","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"hypovolemic shock","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"intestinal hemorrhage","subitem_subject_language":"en","subitem_subject_scheme":"Other"},{"subitem_subject":"abdominal ultrasonography","subitem_subject_language":"en","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":"departmental bulletin paper","resourceuri":"http://purl.org/coar/resource_type/c_6501"}]},"item_title":"大量の消化管出血によりショックに陥ったIgA血管炎の一男児例","item_titles":{"attribute_name":"タイトル","attribute_value_mlt":[{"subitem_title":"大量の消化管出血によりショックに陥ったIgA血管炎の一男児例"},{"subitem_title":"A BOY WITH IGA VASCULITIS WHO DEVELOPED HYPOVOLEMIC SHOCK DUE TO MASSIVE GASTROINTESTINAL HEMORRHAGE","subitem_title_language":"en"}]},"item_type_id":"10002","owner":"25","path":["329"],"pubdate":{"attribute_name":"公開日","attribute_value":"2017-08-08"},"publish_date":"2017-08-08","publish_status":"0","recid":"1223","relation_version_is_last":true,"title":["大量の消化管出血によりショックに陥ったIgA血管炎の一男児例"],"weko_creator_id":"25","weko_shared_id":25},"updated":"2023-06-19T09:41:19.103007+00:00"}