Hemorrhagic Vasculitis (Henoch-Schonlein Purpura) in Pregnancy: Literature Review and Case Report

Abstract

Aim. The paper aims at reviewing publications and analyzing a clinical case of Henoch-Schonlein purpura in a pregnant patient. This pathology is extremely rare in pregnancy (solely about 20 cases reported in the available literature)
 Materials and Methods. A systematic literature search was performed in Pubmed and other sources on peculiarities of gestation in Henoch-Schonlein purpura. A case of Henoch-Schonlein purpura in a pregnant woman, who delivered in 2020 in Lviv Maternity Hospital №1 is presented.
 Results and Discussion. Henoch-Shonlein purpura is extremely rare disease in pregnant women. Only about 20 cases are presented in all available literature. Pregnancy course in described cases was usually favorable. Most patients were delivered by cesarean section for different reasons. About 25% of presented cases were complicated by nephrotic syndrome and superposition of preeclampsia, requiring preterm delivery. No case of placental vasculitis was detected at histological examination of placentas. Our case report: 33-years old patient, primigravida. Henoch-Schonlein purpura diagnosed 8 years ago. The course of the disease was chronic recurrent with predominant skin and joints lesions. Nephrotic syndrome was observed 4 years before pregnancy for last time. The patient continuously received corticosteroid therapy. Course of pregnancy was complicated by mild preeclampsia in the third trimester. A healthy girl weighting 3200g was delivered physiologically at term. No complications were observed in the postpartum period.
 Conclusions. Hemorrhagic vasculitis (Henoch-Shonlein purpura) is an extremely rare disease in pregnancy. In absence of nephrotic syndrome, the course of pregnancy and delivery is favorable, but these patients require\h thorough monitoring for early detection of nephrotic syndrome and/or preeclampsia manifestations.