Henoch-Schonlein Purpura—A Case Report and Review of the Literature

Abstract

We describe a case of an adolescent male with Henoch-Schonlein purpura (HSP), presenting with cutaneous and gastrointestinal manifestations. Endoscopy revealed diffuse ulcerations in the stomach, duodenum, and right colon. Biopsies revealed a leukocytoclastic vasculitis in the skin and gastrointestinal tract. Steroid therapy led to complete resolution of the symptoms. HSP is the most common childhood vasculitis, and is characterized by the classic tetrad of nonthrombocytopenic palpable purpura, arthritis or arthralgias, gastrointestinal and renal involvement. It is a systemic disease where antigen-antibody (IgA) complexes activate the alternate complement pathway, resulting in inflammation and small vessel vasculitis. Mild disease resolves spontaneously, and symptomatic treatment alone is sufficient. Systemic steroids are recommended for moderate to severe HSP. The prognosis depends upon the extent of renal involvement, which requires close followup. Early recognition of multiorgan involvement, especially outside of the typical age group, as in our adolescent patient, and appropriate intervention can mitigate the disease and limit organ damage.

Henoch-Schonlein Purpura Successfully Treated with Dexamethasone: A Case Report of Six-Year-Old Female

“…It has also been proposed that various triggers such as bacterial and viral infections, vaccinations, drugs, and autoimmune mechanisms may result in the formation of an antigen and antibody complex and the deposition of such formed immune complex in the small vessels may activate the alternate complement pathway leading to neutrophil aggregation which results in inflammation and vasculitis. [14] Among all, the preceding infection of β-hemolytic Streptococcus has been one of the most studied cases. The positive throat cultures, as well as increased titers of anti-streptolysin O, have been often found in many patients.…”

A 10-Year-Old Girl with Gastrointestinal Hemorrhage

“…Vasculitis causes extravasation of blood and its components into the interstitial spaces, resulting in edema and hemorrhage. 9 In 2006, the European League Against Rheumatism and Paediatric Rheumatology European Society published a new classification of vasculitis (Table 1). 10 Characteristic symptoms and signs include palpable purpuric rash, abdominal pain, arthralgia, and nephritis.…”

“…Oral steroids are indicated in patients with severe rash, edema, severe colicky abdominal pain (without nausea, vomiting), and renal, scrotal, or testicular involvement. 9 Case Challenge …”

Henoch-Schönlein Purpurasında Serebral Vaskülit

“…HSP is the most common childhood vasculitis, and is characterized by the classic tetrad of nonthrombocytopenic palpable purpura, arthritis or arthralgias, gastrointestinal and renal involvement (15). Its etiology is unclear but is associated with infections (bacterial, viral, parasitic), medications, vaccination, tumors (non-small cell lung cancer, prostate cancer and hematological malignancies), alpha-1-antitrypsin deficiency, and familial Mediterranean fever.…”