Adult Henoch-Schönlein Purpura With Fatal Complications

McCarthy, Rebecca A.; Rosén, Ted; Chen, San Hwan; Raimer, S.

doi:10.1001/archderm.137.1.19

Cited by 16 publications

(10 citation statements)

References 11 publications

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“…The prognosis depends on the complication of glomerulonephritis, but HSP is principally a self‐limiting disease and most of the patients recover without chronic renal failure 1 . Rarely, intestinal perforation, arrhythmia resulting from coronary vasculitis or pulmonary hemorrhage is the cause of a patient's death 7,8 . It seems certain that the current case proceeded through the typical process of HSP, at least in the initial stage of the disease.…”

Section: Discussionmentioning

confidence: 81%

“…1 Rarely, intestinal perforation, arrhythmia resulting from coronary vasculitis or pulmonary hemorrhage is the cause of a patient's death. 7,8 It seems certain that the current case proceeded through the typical process of HSP, at least in the initial stage of the disease. The pathological features seen in the skin biopsy supported the diagnosis and, in addition, endocapillary proliferative glomerulonephritis seemed to be related to HSP.…”

Section: Discussionmentioning

confidence: 85%

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Polyangitis overlap syndrome: A fatal case combined with adult Henoch‐Schönlein purpura and polyarteritis nodosa

Watanabe

Abé

Mishima

et al. 2003

Pathology International

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Henoch-Schönlein purpura (HSP) is a rather common disease characterized by systemic hypersensitivity vasculitis in the skin and other visceral organs. It has a favorable prognosis unless it is complicated by severe glomerular disease. We report a distinctive fatal case of systemic vasculitis combined with HSP and polyarteritis nodosa (PN) in a 56-year-old man who died of progressive renal failure one month after the onset of the disease. He complained of arthralgia, purpura of both lower extremities, nasal bleeding and tarry stool, and acute renal failure was noted at the time of admission to hospital. A skin biopsy from the purpura lesion exhibited leucocytoclastic vasculitis with IgA deposition, and HSP was considered. However, renal failure progressed rapidly and subsequently was complicated by acute myocardial infarction. Postmortem examination revealed PN type necrotizing vasculitis in the kidneys, heart and mesentery resulting in acute multiple infarctions of these organs. We think the current case was a polyangitis overlap syndrome. It is important to suspect the polyangitis overlap syndrome positively when progressive acute renal failure is seen in a patient with HSP and to begin appropriate therapy immediately.

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Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 85%

Polyangitis overlap syndrome: A fatal case combined with adult Henoch‐Schönlein purpura and polyarteritis nodosa

Watanabe

Abé

Mishima

et al. 2003

Pathology International

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“…Henoch-Schonlein purpura is uncommon in adults with few reported cases; however, adult Henoch-Schonlein purpura represents a more severe clinical syndrome with reportedly worse outcomes. 1 Adult Henoch-Schonlein purpura is characterized by a lower frequency of abdominal pain and fever, and a higher frequency of joint symptoms and renal involvement. 2 Clinically, Henoch-Schonlein purpura presents with a classic tetrad of symptoms (with reported frequencies): cutaneous purpura (100%), arthralgia or arthritis (82%), abdominal pain (63%), gastrointestinal bleeding (33%).…”

Section: Discussionmentioning

confidence: 99%

Henoch–Schonlein purpura with ischaemic bowel

Hameed

Dua²,

Taylor³

2008

Ann R Coll Surg Engl

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“…Pulmonary-renal syndrome in an adult due to HSP confirmed by histology and immunohistochemistry has only been reported in four patients in the literature, two of whom died and two of whom responded to treatment with prednisolone [6][7][8][9]. In addition, two papers have described patients with suspected HSP and pulmonary haemorrhage, but the absence of immunoglobulins and C3 in the mesangium at necropsy cast doubt on the diagnosis in the first case and, in the second, the authors could not demonstrate vasculitis in the lungs [10][11][12].…”

Section: Discussionmentioning

confidence: 99%

A 47-year-old male with respiratory and renal failure

Jaiswal

Packham

Stevens

et al. 2005

Breathe

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A 47-year-old male was admitted with a 5-day history of painful, red, swollen legs, and 48 hours of intermittent sweats and rigors. His only previous medical history was Perthe's disease of the right hip at the age of 8 years. He had no allergies and there was no family history. He was taking ampicillin at a dose of 500 mg t.d.s., as prescribed by his general practitioner. He had a temperature of 39°C on admission. Physical examination proved normal, apart from the area of skin over both ankles and the lower right leg, which was swollen, red, hot and tender.Initial investigations revealed leukocytosis of 15.9x10 -9 , neutrophils 11.7x10 -9 and a C-reactive protein level of 70.5 (normal range 0-10). Renal function and serum electrolytes were normal. Chest and ankle radiographs were also normal. Hip radiography revealed changes consistent with old Perthe's disease. Blood cultures were negative. A diagnosis of cellulitis was made by the admitting physicians, and the patient was prescribed intravenous benzylpenicillin and flucloxacillin.The leukocytosis resolved, but the patient continued to experience a fluctuating temperature. Nine days after admission, he developed non-specific abdominal pains. An ultrasound of the abdomen, kidneys and renal tract proved normal. The next day, he developed a rash on both legs (figure 1).

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Adult Henoch-Schönlein Purpura With Fatal Complications

Cited by 16 publications

References 11 publications

Polyangitis overlap syndrome: A fatal case combined with adult Henoch‐Schönlein purpura and polyarteritis nodosa

Polyangitis overlap syndrome: A fatal case combined with adult Henoch‐Schönlein purpura and polyarteritis nodosa

Henoch–Schonlein purpura with ischaemic bowel

A 47-year-old male with respiratory and renal failure

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