Adult Henolch-Schonlein purpura: multiorgan failure in the setting of a purpuric rash

Maxfield, Luke; Peck, Aurora; Youngblood, Laura

doi:10.1136/bcr-2018-224816

Cited by 4 publications

(2 citation statements)

References 14 publications

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“…Gastrointestinal involvement in adults may be severe and may require surgical management. 5,6 In at least one case, in an older patient at 63 years of age, it resulted in death due to extensive bowel necrosis and hemorrhage as well as renal failure. 7 In adults, GI manifestations are less frequent, and HSP more frequently results in development of arthritis or renal failure, in certain extreme cases requiring dialysis.…”

Section: Discussionmentioning

confidence: 99%

Henoch-Schonlein Purpura in the Adult, a Case Report

Virovets¹,

Biggs²

2020

JETEM

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This case report describes a dermatologic finding that is not typical in the adult population, but may be medically significant. A 39-year-old female patient with a past medical history that was negative for autoimmune disorders, vasculitides, or chronic infectious disease presented to our emergency department for evaluation of a painful rash on the bilateral lower extremities. She complained of two days of worsening raised, erythematous, pruritic and painful patches around both ankles, some of which had opened to become weeping sores. There was surrounding edema of both extremities. She denied any systemic symptoms. Online literature, primarily UpToDate was reviewed, and it was suspected that her rash may have been Henoch-Schönlein Purpura (HSP), given her lack of other medical history and a visual appearance that seemed consistent with the condition. To evaluate for renal involvement and systemic inflammation, labs were drawn and were grossly unremarkable except for a mild elevation in her C-reactive protein with a level of 37.6 mg/L. She was treated with intravenous (IV) hydration and IV ketorolac, with resultant symptomatic improvement. Since she did not have any apparent systemic involvement, she was discharged to follow up with rheumatology, with a recommendation to take over the counter non-steroidal anti-inflammatory drugs (NSAIDs). The patient was ultimately seen by rheumatology several months later, and a biopsy of the lesions demonstrated what appeared to be Henoch-Schönlein Purpura given her clinical presentation. Henoch-Schönlein Purpura can occur in adults, however rare, requiring close follow-up since in the adult population, it may result in renal failure and need for dialysis.

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Section: Discussionmentioning

confidence: 99%

Henoch-Schonlein Purpura in the Adult, a Case Report

Virovets¹,

Biggs²

2020

JETEM

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“…Purpura and cutaneous relapses are also common. 7 Recurrences occur in 30-40% of individuals during the first year of illness, although they are usually less severe and short-lived than the original symptoms. 2…”

Section: Introductionmentioning

confidence: 99%

Henoch-Schonlein Purpura in Adult with Gastrointestinal and Renal Involvement

Devi

Umborowati

Anggraeni

et al. 2023

BIKK

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Background: The pathogenesis of Henoch-Schonlein Purpura (HSP), a multisystem organ-involved small vessel vasculitis, is unknown. HSP is more common in youngsters than in adults. HSP is associated with a history of malignancies, medications, vaccinations, and upper respiratory tract infections. Painful purpura, arthritis, stomach discomfort, and renal involvement are symptoms that may be seen in HSP patients. Adult patients had a much higher rate of renal involvement than children. Purpose: To report a case of HSP in an adult with gastrointestinal and renal involvement. Case: A 45-year-old man complained of an arm, leg, and waist rash for two weeks before admission to the hospital. He also has stomach pains, nausea, and vomiting to deal with. His symptoms have just appeared now for the first time. During a renal function test, blood urea nitrogen (BUN) and creatine serum levels rose. On a urinalysis, proteinuria and microscopic hematuria were found. Leucocytoclastic vasculitis was discovered during the histopathology investigation. HSP diagnosis was based on the ACR and ICC criteria. The patient was given 3x2 tablets of 0.5 mg dexamethasone, 3x2 tablets of cetirizine, 2x10 mg lisinopril, 2x50 mg ranitidine injection, and 2 grams ceftriaxone. Discussion: The clinical symptoms of HSP are used to make the diagnosis. In the vast majority of instances, the treatment is only supportive therapy. Corticosteroid usually are usually used for HSP with multisystem organ involvement to reduce pain severity and faster resolution of renal manifestation. Conclusion: Follow up on renal function is needed to monitor the worsening of renal disease.

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