Henoch-Schönlein purpura associated with esophagus carcinoma and adenocarcinoma of the lung

Weiler-Bisig, D; Ettlin, G; Brink, Thaddeus S.; Arnold, W; Glatz-Krieger, Katharina; Fischer, Alice

doi:10.5414/cnp63302

Cited by 22 publications

(6 citation statements)

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“…Therapies for lung cancer induced remission of HSP in some cases [9,10,15,16], whereas other case reports indicated that corticosteroid therapy was required for improvement of HSP [11,14,17,18], as with our case. Our patient had an Eastern Cooperative Oncology Group performance status of 1, and after treatment of the HSP to correct the progressive renal insufficiency, there was no contraindication for chemotherapy.…”

Section: Discussionsupporting

confidence: 51%

Henoch Schönlein purpura associated with pulmonary adenocarcinoma

et al. 2011

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IntroductionHenoch-Schönlein purpura is a common immunoglobulin A-mediated vasculitis syndrome in children. Henoch-Schönlein purpura can also affect adults and is probably related to malignancy.Case presentationWe report the case of a 61-year-old Japanese man who presented for examination after an abnormal shadow was detected by chest radiography. He received a diagnosis of pulmonary adenocarcinoma, stage IV. Purpura on the legs, abdominal pain, diarrhea, hematuria and proteinuria developed at this time. Henoch-Schönlein purpura was diagnosed, base on the clinical symptoms and histological findings of biopsy specimens of the skin, which showed vasculitis with immunoglobulin A deposits. Our patient received chemotherapy with gemcitabine after successful steroid therapy for the Henoch-Schönlein purpura.ConclusionAlthough hematological malignancies are well-known causes of vasculitides, cases of Henoch-Schönlein purpura associated with lung adenocarcinoma are rare. Our patient was treated with corticosteroid therapy, which cleared the purpura and cytotoxic chemotherapy for the non-small cell lung cancer. However, he died from heart failure due to cardiac tamponade.

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Section: Discussionsupporting

confidence: 51%

Henoch Schönlein purpura associated with pulmonary adenocarcinoma

et al. 2011

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“…In Table 5 we summarize the cases that were previously reported on the association between Henoch-Schönlein purpura and malignancies. 2 – 6 , 10 , 18 , 22 – 24 , 29 , 31 , 33 , 38 , 41 , 44 – 46 , 63 , 65 , 76 , 78 , 80 , 84 , 89 , 95 , 98 , 101 , 102 …”

Section: Discussionmentioning

confidence: 99%

The Spectrum of Paraneoplastic Cutaneous Vasculitis in a Defined Population

Loricera

Calvo-Río²,

Sanjuán³

et al. 2013

Medicine

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Cutaneous vasculitis may be associated with malignancies, and may behave as a paraneoplastic syndrome. This association has been reported in a variable proportion of patients depending on population selection. We conducted the current study to assess the frequency, clinical features, treatment, and outcome of paraneoplastic vasculitis in a large unselected series of 766 patients with cutaneous vasculitis diagnosed at a single university hospital.Sixteen patients (10 men and 6 women; mean age ± standard deviation, 67.94 ± 14.20 yr; range, 40–85 yr) presenting with cutaneous vasculitis were ultimately diagnosed as having an underlying malignancy. They constituted 3.80% of the 421 adult patients. There were 9 hematologic and 7 solid underlying malignancies. Skin lesions were the initial clinical presentation in all of them, and the median interval from the onset of cutaneous vasculitis to the diagnosis of the malignancy was 17 days (range, 8–50 d). The most frequent skin lesions were palpable purpura (15 patients). Other clinical manifestations included constitutional syndrome (10 patients) and arthralgia and/or arthritis (4 cases). Hematologic cytopenias (11 cases) as well as immature peripheral blood cells (6 cases) were frequently observed in the full blood cell count, especially in those with vasculitis associated with hematologic malignancies.Specific treatment for vasculitis was prescribed in 10 patients; nonsteroidal antiinflammatory drugs (4 patients), corticosteroids (3 patients), chloroquine (1 patient), antihistamines (1 patient), and cyclophosphamide (1 patient). Ten patients died due to the malignancy and 6 patients recovered following malignancy therapy. Patients with paraneoplastic vasculitis were older, more frequently had constitutional syndrome, and less frequently had organ damage due to the vasculitis than the remaining patients with cutaneous vasculitis.In summary, cutaneous paraneoplastic vasculitis is an entity not uncommonly encountered by clinicians. The most common underlying malignancy is generally hematologic. In these cases the presence of cytopenias and immature cells may be red flags for the diagnosis of cancer. In patients with paraneoplastic cutaneous vasculitis, the prognosis depends on the underlying neoplasia.

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“…5 Acute gastrointestinal complications, such as bleeding and intussusception, are more common in HSP. 6 HSP also occurs in adults most often in response to infections; however it has also been linked to underlying respiratory and gastrointestinal tract malignancies, [7][8][9] with some authors recommending that men over the age of 40 years with HSP and no precipitating factors be worked up for occult malignancy. 8 Thus early and accurate diagnosis would have implications for follow-up.…”

Section: Introductionmentioning

confidence: 99%