4) 血管炎症候群（Schönlein-Henoch紫斑病，Churg-Strauss症候群，結節性多発動脈炎）

Vasculitis Syndrome (Schönlein-Henoch Purpura, Churg-Strauss Syndrome, Polyarteritis Nodosa)

要旨　血管炎症候群は血管壁の炎症を来し，種々の臨床症状を呈する全身性炎症性疾患の総称である．障害される血管の部位と太さにより，大型血管炎，中型血管炎，小型血管炎に分類され，それぞれ異なる臨床像を呈する．これらの疾患では，臓器症状の1つとして消化管病変をしばしば認め，腹痛や消化管出血，穿孔などの症状を伴う．これらの症状は時に全身症状や皮膚所見に先行してみられ，日常診療において診断に難渋することも少なくない．治療にあたってはステロイド剤や免疫抑制剤を用いるが，時に致死的合併症を生じる場合があり，早期診断，早期治療が極めて重要である．

　Vasculitis syndrome causes the inflammation of vessel walls, and it is the general term for a systemic inflammatory disorder that presents various kinds of clinical manifestations. By the size of the vessel that it predominantly affects, it is classified into large vessel vasculitis, medium vessel vasculitis, and small vessel vasculitis and develops a clinical picture that varies according to its type. These disorders often indicate gastrointestinal lesions as the symptoms of one of the organs and are accompanied with stomachache or haemorrhage or perforation of the digestive tract. These symptoms sometimes precede systemic symptoms and skin findings, and it is not rare for these symptoms to be difficult to diagnose in common practice. We use a steroid and an immunosuppressive drug in treatment, but there are cases that sometimes result in lethal complications. Therefore early diagnosis and early treatment are extremely important in patients with vasculitis syndrome.