Posterior reversible encephalopathy syndrome in Henoch–Schönlein purpura

Lava, Sebastiano A. G.; Peeters, Gabriëlla G. A. M.; Bianchetti, Mario G.; Simonetti, Barbara Goeggel; Simonetti, Giacomo D.; Milani, Gregorio P.

doi:10.1007/s00296-016-3577-1

Cited by 19 publications

(20 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Those cases presenting with the pulmonary symptoms included cough, haemoptysis, epistaxis, dyspnea, tachypnea, chest pain, and shortness of breath through to acute respiratory failure. Therefore, atypical presentations affecting multiple systems should be considered in the outcome of HSP and the possibilities of different responses (20)(21)(22).…”

Section: Discussionmentioning

confidence: 99%

Demographic, Epidemiologic and Clinical Analyses of Paediatric Patients Hospitalized with Henoch-Schonlein Purpura: A Retrospective Study

Gökçe¹,

Dörtkardeşler²,

Aslan³

2021

jpr

View full text Add to dashboard Cite

This vasculitis is described by the triad of palpable purpura, abdominal pain, and arthritis. Purpuric skin lesions are the most common clinical findings in HSP followed by joint, gastrointestinal tract, and kidney involvement. ABS TRACTAim: Henoch-Schönlein purpura (HSP) is the most common systemic vasculitis in children. The purpose of this study was to assess the clinical, epidemiological, and laboratory features of 117 children diagnosed with HSP.Materials and Methods: This study was conducted to evaluate the data of 117 children with HSP, retrospectively. The presence of the cardinal clinical findings such as purpura, abdominal pain, and arthralgia; and the presence of increased erythrocyte sedimentation rate, decreased serum C3 levels, leukocytosis, blood in the stool, haematuria, and proteinuria were assessed in children with HSP.Results: Of the 117 patients enrolled in the study, 68 were males (58.1%) and 49 were females (41.9%). The median age was 85 (49) months. Purpuric skin lesions were detected in ninety-eight (97.9%) patients, arthritis/arthralgia in 71 (60.6%), gastrointestinal involvement in 52 (44.4%), and renal involvement in 27 (23%) patients. The median duration of hospitalization day was 6 (10) days. Non-palpable purpuric skin lesions mostly located on ankles were the most common involvement in the patients. Conclusion:Non-palpable purpuric skin lesions were the most common presentations followed by arthritis/arthralgia, and gastrointestinal involvement in our patients. Seasonal distributions, gender, and ages of the patients were concluded to be noncontradictory compared with the literature. Although variable clinical findings in the patients were found, the cardinal features of HSP were determined in almost all subjects in this study.

show abstract

Section: Discussionmentioning

confidence: 99%

Demographic, Epidemiologic and Clinical Analyses of Paediatric Patients Hospitalized with Henoch-Schonlein Purpura: A Retrospective Study

Gökçe¹,

Dörtkardeşler²,

Aslan³

2021

jpr

View full text Add to dashboard Cite

show abstract

“…Indeed, in both patients previously presented, the rashes subsided within four weeks without any medical intervention. Other unusual presentations of IgA vasculitis include pulmonary hemorrhage, pancreatitis and cholecystitis, and cerebrovascular disease that can potentially cause permanent neurological deficits 37‐39 . We have encountered one patient with IgA vasculitis presenting as pulmonary‐renal syndrome.…”

Section: Discussionmentioning

confidence: 99%

“…Other unusual presentations of IgA vasculitis include pulmonary hemorrhage, pancreatitis and cholecystitis, and cerebrovascular disease that can potentially cause permanent neurological deficits. [37][38][39] We have encountered one patient with IgA vasculitis presenting as pulmonary-renal syndrome. Pulmonary involvement in the form of pulmonary hemorrhage, known as diffuse alveolar hemorrhage (DAH), is a rare feature of IgA vasculitis and when encountered with rapidly progressive glomerulonephritis is termed pulmonary-renal syndrome.…”

Section: Iga Vasculitis and Risk Factors For Renal Involvement In Patients Agedmentioning

confidence: 99%

Clinical spectrum and outcome of immunoglobulin A vasculitis in children: A 10‐year clinical study

AlKhater

Moaigel

2021

Int J Clin Pract

View full text Add to dashboard Cite

Background Immunoglobulin A (IgA) vasculitis is the most common vasculitides of childhood. The aim of this study was to characterise the disease and identify clinical and laboratory factors associated with renal involvement. Methods Medical records of children aged ≤18 years with the diagnosis of IgA vasculitis according to the EULAR/PRES criteria were retrospectively reviewed for demographic data, clinical manifestations and laboratory tests. Factors associated with renal involvement were determined using multivariable logistic regression analysis. Results A total of 113 patients were involved in the study. There were 57.5% of males (male: female ratio of 1.4:1). The mean (SD) age was 7.1 (3.0) years. Most of the patients presented during the fall (37.2%) and winter (29.2%). The most common presenting complaints were skin rash (83.2%) and arthralgia (9.7%). The most frequent presentation of the skin was palpable purpuric rash, except for two patients (1.8%) presenting with blistering eruptions in the form of hemorrhagic bullae and ecchymoses of both extremities. We have encountered one patient with pulmonary‐renal syndrome. Renal involvement was found in 27.4% of the patients. In the multivariate analysis, the strongest factors associated with renal involvement were older age and elevated creatinine level. Factors that improved model fit were higher platelet and lower white blood cell counts, elevated anti‐streptolysin O and a history of preceding infection. Conclusion The clinical profile of the disease in our cohort was similar to other reports. However, we have encountered a few severe and rare atypical presentations. Over a quarter of children in our setting had renal involvement. Children presenting with these risk factors need to be closely monitored and long‐term follow‐up is recommended.

show abstract

“…In two of the cases, however, there is no arterial hypertension [10, 32]. Recently published systematic literature review on the occurrence of PRES in HSP found only 17 cases of HSP complicated by PRES [35]. …”

Section: Discussionmentioning

confidence: 99%

Central Nervous System Involvement in Henoch-Schonlein Purpura in Children and Adolescents

Pacheva

Ivanov

Stefanova

et al. 2017

Case Reports in Pediatrics

View full text Add to dashboard Cite

Central nervous system (CNS) involvement in Henoch-Schonlein purpura (HSP) is rare but poses diagnostic difficulties. The aim of the study was to establish the frequency of CNS involvement in HSP, to analyze its clinical characteristics and do a literature review. Medical files of patients with HSP admitted at the Department of Pediatrics, Plovdiv, were studied retrospectively for a five-year period (2009–2013). Diagnosis was based on the American College of Rheumatology criteria. Out of 112 children with HSP 1 case (0.9%) had CNS involvement presenting as Posterior Reversible Encephalopathy Syndrome (PRES), which may be a result of CNS vasculitis or arterial hypertension. It was an 8-year-old girl with atypical HSP which started with abdominal pain requiring surgery. On the third day after the operation a transient macular rash and arterial hypertension appeared, followed by visual disturbances, hemiconvulsive epileptic seizures, postictal hemiparesis, and confusion. Head CT showed occipital hypodense lesions and MRT-T2 hyperintense lesion in the left occipital lobe. The patient experienced a second similar episode after 2 weeks when palpable purpura had also appeared. Neurological symptoms and MRI resolved completely. HSP can be an etiological factor for PRES in childhood. Although PRES is a rare complication of HSP, clinicians must be aware of it and avoid diagnostic and therapeutic delays.

show abstract

Posterior reversible encephalopathy syndrome in Henoch–Schönlein purpura

Cited by 19 publications

References 17 publications

Demographic, Epidemiologic and Clinical Analyses of Paediatric Patients Hospitalized with Henoch-Schonlein Purpura: A Retrospective Study

Demographic, Epidemiologic and Clinical Analyses of Paediatric Patients Hospitalized with Henoch-Schonlein Purpura: A Retrospective Study

Clinical spectrum and outcome of immunoglobulin A vasculitis in children: A 10‐year clinical study

Central Nervous System Involvement in Henoch-Schonlein Purpura in Children and Adolescents

Contact Info

Product

Resources

About