Henoch-Schonlein purpura in pregnancy

Abstract

Henoch-Schönlein purpura (HSP) is an IgA-mediated small vessel vasculitis which commonly involves the skin, gastrointestinal system and kidneys. Numerous HSP triggers have been identified, and pregnancy has been reported as an exacerbating factor. After a pregnant woman had been diagnosed as having new-onset HSP, we reviewed all cases of immunofluorescence-proven HSP evaluated by the Department of Dermatology at the Johns Hopkins Hospital between 1990 and 2002, and report three cases of HSP occurring during pregnancy. Two patients developed new-onset HSP, one at 16 weeks gestation and one at 22 weeks, while the third developed a recurrence of HSP at 12 weeks gestation after 19 years of remission. We conclude that pregnancy may be a trigger for HSP onset or recurrence in susceptible individuals.

Henoch–Schonlein purpura in pregnancy

“…In the whole literature, only 16 cases of HSP have been reported (14 in English, one in Japanese and one in Spanish) (Barquero-Romero et al 2006;Koizumi et al 2004;Cummins et al 2003;Ekoukou et al 1997;Le Goff et al 1997;Yasukawa et al 1996;Muszytowski and Ruszkiewicz-Folda 1996;Merill and Lahita 1994;Miyata et al 1994;Itoh et al 1994;Wilks et al 1993;Joseph et al 1987;Siroty 1985;Ray and Posen 1985;McCoy 1981;Plauche 1980). Therefore, this case is the 17th case reported worldwide in the literature.…”

“…Eleven women (Barquero-Romero et al 2006;Koizumi et al 2004;Cummins et al 2003;Ekoukou et al 1997;Le Goff et al 1997;Yasukawa et al 1996;Muszytowski and Ruszkiewicz-Folda 1996;Itoh et al 1994;Wilks et al 1993;Siroty 1985;McCoy 1981) revealed the disease during pregnancy and finally one of them postpartum (Miyata et al 1994). Renal involvement is more frequent and severe in adults than in childhood (Blanco et al 1997), but it usually has an excellent outcome.…”

“…For this reason, the differential diagnosis from pre-eclampsia and eclampsia is necessary during pregnancy. It should be mentioned that the IgA immunoglobulins do not cross the placenta and so there is no risk for the fetus (Cummins et al 2003). Henoch-Schonlein purpura usually resolves without permanent complications.…”

Henoch-Schönlein purpura in the third trimester of pregnancy

“…In the available literature there is a case report of HSP recurrence in the 12th gestational week, following 19 years of remission. Therefore, pregnancy should be on the list of possible triggers for HSP in susceptible individuals ( 31 ).…”

Henoch schonlein purpura in pregnancy: a lesser known phenomenon

“…Cummins et al 13 reported two patients developing new onset HSP at 16 & 22 weeks gestation respectively while the third developing a recurrence of HSP at 12 weeks gestation after 19 years of remission thereby concluding that pregnancy may be a trigger for onset or recurrence for HSP in susceptible individuals. Feldman et al 14 reported a 35 year old primigravida at 31 weeks of gestation with history of purpura on the legs, epigastric pain and arthralgia.…”