Life-threatening complications of Henoch-Schönlein purpura: diffuse alveolar haemorrhage, venous thrombosis and bowel ischaemia

Dhaliwal, Kezreen Kaur; Lile, Nur Atikah; Lim, Chong Hong

doi:10.1136/bcr-2020-235905

Cited by 4 publications

(5 citation statements)

References 24 publications

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“…It may affect the skin, joints, gastrointestinal tract, and kidneys. HSP can be complicated by venous thrombosis[ 30 , 31 ], but there was no evidence of HSP before the occurrence of thrombosis in this child. It is not clear whether IHES and HSP have a common pathogenesis.…”

Section: Discussionmentioning

confidence: 99%

Development of Henoch-Schoenlein purpura in a child with idiopathic hypereosinophilia syndrome with multiple thrombotic onset: A case report

Xu¹,

Xiao-bi²,

Wang³

et al. 2023

World J Clin Cases

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BACKGROUND The incidence of pulmonary embolism (PE) in children is low, but its mortality is high. Hypereosinophilic syndrome (HES) is a group of diseases caused by an abnormal increase in eosinophilic granulocytes resulting in multiple-organ dysfunction. The urgent event of thromboembolism in the pulmonary region provoked by eosinophils in idiopathic HES (IHES) is relatively unusual. This article reports a case of IHES with multiple PEs and left leg venous thrombosis as the first manifestation. One month later, the patient developed Henoch-Schonlein purpura (HSP), which is very rare. CASE SUMMARY We report the case of a 12-year-old boy who was admitted to the hospital with dyspnea, left leg pain, and aggravation. He had bilateral PE and left leg venous embolism with mild eosinophilia. Low-molecular-weight heparin and urokinase were given. At the same time, the interventional department was contacted about filter implantation, followed by urokinase thrombolysis. The left leg thrombus was aspirated under ultrasound guidance. He was discharged from the hospital on rivaroxaban. One month later, he developed a rash on both legs and ankle pain consistent with HSP, with severe eosinophilia and motor and sensory disturbances. The patient was diagnosed with IHES with multiple embolisms complicated by HSP after excluding other causes of the eosinophil elevation. After glucocorticoid treatment, the symptoms were relieved, but the patient later developed purpura nephritis. CONCLUSION We report a rare and life-threatening case of IHES with multiple embolisms associated with HSP. A mild elevation of eosinophils early in the disease leads to difficulties in diagnosis and delayed treatment.

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Section: Discussionmentioning

confidence: 99%

Development of Henoch-Schoenlein purpura in a child with idiopathic hypereosinophilia syndrome with multiple thrombotic onset: A case report

Xu¹,

Xiao-bi²,

Wang³

et al. 2023

World J Clin Cases

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“…Ig-A vasculitis is a childhood disease caused by inflammation of the small blood vessels (vasculitis) [1][2][3][4][5][6][7][8][9][10][11]. It can affect the skin, intestines, kidneys and joints.…”

Section: Discussionmentioning

confidence: 99%

“…The disease usually resolves within 4 weeks without late health effects. Purpura Schönlein-Henoch is the most common inflammatory vascular disease in young children and school-age children [1][2][3][4][5][6][7][8][9][10][11]. The disease always affects the skin.…”

Section: Discussionmentioning

confidence: 99%

Immunglobulin-A Mediated Vasculitis in |A 9 Years-Old Boy

Bittmann¹

2023

AJBSR

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“…Das macht die Diagnostik manchmal schwer. Mit Ausnahme der lokalisierten Verlaufsformen (limitierter LE, jlSc) sind alle anderen Kollagenosen als Systemerkrankungen aufzufassen, die potentiell Organschäden verursachen und sogar lebensbedrohliche Verläufe haben können [8-10].…”

Section: Einführungunclassified

Langfristentwicklungen in der Kinder- und Jugendrheumatologie

Haas¹,

Minden²

2023

Kompass Autoimmun

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Im Gebiet der Kinderrheumatologie gab es in den letzten Jahrzehnten immense Fortschritte, die sowohl die Diagnostik, als auch die Therapie nachhaltig verbessert haben. Obwohl erst seit 2003 in Deutschland offiziell als Zusatzbezeichnung anerkannt, stehen heutzutage über 200 Kinder- und Jugendrheumatologen (d.h. 1,4 Kinderrheumatologen pro 100 000 Kinder) für die Erkennung und Behandlung von rheumatischen Erkrankungen bei Kindern und Jugendlichen bundesweit zur Verfügung. Neue Erkenntnisse in der Pathogenese rheumatischer Erkrankungen und die sich stetig weiterentwickelnde genetische Diagnostik haben das rheumatische Krankheitsspektrum und die Behandlungsmöglichkeiten dramatisch erweitert. Internationale Forschungsnetzwerke und eine spezielle Gesetzgebung für die Entwicklung von pädiatrischen Medikamenten führten zur Zulassung von zahlreichen neuen Rheumamedikamenten, deren Sicherheit im klinischen Alltag seit der Jahrtausendwende systematisch in Deutschland untersucht wird. Maßnahmen zur Sicherung der Versorgungsqualität wurden implementiert, Standardinstrumente zur Bewertung der Krankheitsaktivität und Krankheitslast aus Patientensicht eingeführt sowie Initiativen zur Verbesserung der Versorgung Betroffener (z.B. die ProKind-Initiative) auf den Weg gebracht. Diese Veränderungen haben die Prognose und Lebensperspektive rheumakranker Kinder und Jugendlicher verbessert, wenngleich noch weiterer Optimierungsbedarf besteht.

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Life-threatening complications of Henoch-Schönlein purpura: diffuse alveolar haemorrhage, venous thrombosis and bowel ischaemia

Cited by 4 publications

References 24 publications

Development of Henoch-Schoenlein purpura in a child with idiopathic hypereosinophilia syndrome with multiple thrombotic onset: A case report

Development of Henoch-Schoenlein purpura in a child with idiopathic hypereosinophilia syndrome with multiple thrombotic onset: A case report

Immunglobulin-A Mediated Vasculitis in |A 9 Years-Old Boy

Langfristentwicklungen in der Kinder- und Jugendrheumatologie

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