Henoch-Schönlein Purpura after <i>Salmonella hirschfeldii </i>Infection

Abstract

The authors present a case of Henoch-Schönlein purpura in a young soldier (19 years old) which they consider important for its etiology and the length of its oligoanuric phase. The syndrome followed a Salmonella hirschfeldii infection, and a protracted oligoanuric phase was followed by nephrotic syndrome and selective glomerular proteinuria which lasted for 1 year. The young man recovered after the eradication of the Salmonella. It seems possible that there was an overall anomalous regulation of the ‘lymphoid system of the mucosa’, perhaps dependent on a genetic predisposition.

Relapsing Henoch-Sch&ouml;nlein Purpura Associated with a Tubo-Ovarian Abscess due to <i>Morganella morganii</i>

“…Interestingly, in Beaufils' series of 11 patients with acute renal failure of glomerular origin during visceral abscesses, 1 developed a focal segmental proliferative glomerulone phritis with mesangial IgA deposition, secondary to a pul monary abscess due to Pseudomonas aeruginosa [9], Our patient's course of relapsing HSP associated with a tubo-ovarian abscess resembles that of Fiocchi et al [8] and is analogous to the cases described by Beaufils et al [9], The large size of the multiloculated abscess indicates a chronic infection of long duration. Although ovarian involvement in HSP may have been the initiating factor in the formation of the abscess, the fact that the patient's exacerbations remitted after its eradication, support a role of the infection in the pathogenesis of HSP.…”

“…Fiocchi et al [8] describe the occurrence of HSP in conjunction with Salmonella hirschfeldii septicemia [8]. The manifestations of the syndrome remitted after suc cessful treatment of the infection.…”

“…Other agents reported to have preceded HSP have included Yersinia [3], Legionella [2], Myco plasma [4], parovirus [5], adenovirus [6], varicella and Epstein-Barr virus [2]. HSP has also been described in association with pulmonary tuberculosis [7] and salmo nella infection [8].…”

Gastrointestinal Manifestations of Henoch-Schonlein Purpura

“…As for GI triggers, HSP has been associated with campylobacter [34], shigellosis [35], salmonella typhi and nontyphi [36,37], hepatitis A [38], hepatitis B [39], hepatitis B vaccination [40], celiac sprue [41], amebiasis [42], cytomegalovirus [43], cirrhosis [44,45], and alpha-1 antitrypsin deficiency [46]. Whether these diseases are truly linked to HSP or occur together coincidentally is unknown.…”

Immunoglobulin A‐associated lymphocytic vasculopathy: a clinicopathologic study of eight patients

“…Secretory IgA from most mucosal surfaces comprises dimers of IgA2 complexed to a secretory piece which facilitates mucosal transport and deters degradation. In classic neutrophil‐rich IgA vasculitis, various inciting triggers include mucosal infection that generates immune complexes comprising microbial antigens and mucosal IgA hematogenously disseminated through a compromised mucosal barrier 4, 23–27 . The pathogenetic basis of vascular injury in the skin may be similar in the setting of IBD 8 .…”