Henoch-SchöNlein Purpura in Adults

Meiller, María José López; Cavallasca, Javier A.; Maliandi, María del Rosario; Nasswetter, G

doi:10.1590/s1807-59322008000200018

Cited by 29 publications

(33 citation statements)

References 8 publications

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“…Occasionally diagnosis may be less clear, requiring skin biopsies to examine for IgA deposition. A large amount of IgA deposits in the organ being tested favors the diagnosis of HSP [45]. …”

Section: Diagnosis and Radiologymentioning

confidence: 99%

Urological Manifestations of Henoch-Schonlein Purpura: A Review

et al. 2015

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Henoch-Schonlein purpura (HSP) is an immune-mediated systemic vasculitis generally found in children. The standard manifestations of HSP are palpable purpura, arthritis, abdominal pain, and renal complications. Although less common, there are significant urological manifestations associated with HSP. The primary objective of this review is to encourage better understanding and management of HSP by emphasizing the common and rare manifestations of HSP, how they are diagnosed, and the latest treatment options for mild to severe complications. Medline searches of HSP and its urological manifestations were conducted along with searches on current diagnostic and treatment methods. Urological manifestations of HSP involve the kidney, ureter, bladder, prostate, scrotum, testicle, and penis. Diagnosis and management of HSP are not always clear due to differential diagnosis and diversity of symptom presentation. Treatment for HSP is mainly supportive and includes use of nonsteroidal anti-inflammatory drugs for pain relief. In more severe cases, glucocorticoids, methylprednisolone, plasmapheresis, and peritoneal and hemodialysis are reported successful. It is important to note different symptoms of HSP in order to distinguish HSP from other diseases. Early diagnosis may prevent severe complications. Treatment options vary from conservative to invasive depending on the severity of the disease and time frame of diagnosis.

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Section: Diagnosis and Radiologymentioning

confidence: 99%

Urological Manifestations of Henoch-Schonlein Purpura: A Review

et al. 2015

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“…Though this is the most common vasculitis affecting children, HSP has been documented rarely in the adult population. The annual incidence in adults ranges from 3.4 to 14.3 cases per million, depending on the study …”

Section: Discussionmentioning

confidence: 99%

Resolution of sinus bradycardia, high‐grade heart block, and left ventricular systolic dysfunction with rituximab therapy in Henoch‐Schonlein purpura

Torosoff

Breen

Balulad

et al. 2018

Internal Medicine Journal

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Henoch-Schonlein purpura (HSP) is a rare, typically self-limited, multi-organ vasculitis. Cardiac involvement with HSP carries high morbidity and mortality, thus requiring early aggressive immunosuppressive therapy. We report a case of HSP complicated with acute systolic left ventricular (LV) dysfunction, symptomatic sinus bradycardia and high-grade atrio-ventricular (AV) heart block. Cyclophosphamide, a commonly used agent in HSP, was contraindicated due to the patient's presentation with acute renal failure. Treatment with monoclonal antibody rituximab and corticosteroids was initiated with an improvement in and resolution of LV systolic dysfunction, sinus bradycardia and AV block. We believe this is the first published report on rituximab treatment in HSP with cardiac involvement manifesting with severe LV systolic dysfunction, sinus bradycardia and high-grade AV block.

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“…In addition, a randomizedcontrolled trial about IVCY demonstrated that the addition of cyclophosphamide to steroid administration provides no benefit compared with steroid administration alone [16]. On the other hand, there have been a few reports that IVCY is effective for severe HSPN [17,18]. In fact, IVCY is effective for other types of systemic vasculitis, such as lupus nephritis and Wegener granulomatosis, with renal involvement.…”

Section: Discussionmentioning

confidence: 99%

An adult case of severe steroid-resistant Henoch–Schönlein purpura nephritis treated with intravenous cyclophosphamide and tonsillectomy

et al. 2016

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A previously healthy 37-year-old Canadian man living in Japan visited a hospital in Thailand while traveling because of edematous legs, purpura, arthralgia, bloody stool, and fever after an insect bite. Henoch-Schönlein purpura (HSP) was suspected. His creatinine level was 5.2 mg/dL. He was treated with oral prednisolone (PSL) and oral cyclophosphamide (CPA); after treatment, his creatinine level improved to 2.4 mg/dL. Upon returning to Japan, he was admitted to the National Center for Global Health and Medicine Hospital in Tokyo. A kidney biopsy was performed, and HSP nephritis (HSPN) was diagnosed. Renal dysfunction and proteinuria persisted despite 4 administrations of steroid-pulse therapy and 3 sessions of plasma exchange. Finally, he was treated with intravenous cyclophosphamide (IVCY). His creatinine level and proteinuria markedly improved. His microscopic hematuria disappeared after he underwent tonsillectomy. There have been only a few case reports describing patients with adult-onset HSPN necessitating IVCY. We present here a rare case of steroid-resistant HSPN treated with IVCY and tonsillectomy, with reference to some recent findings.

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Henoch-SchöNlein Purpura in Adults

Cited by 29 publications

References 8 publications

Urological Manifestations of Henoch-Schonlein Purpura: A Review

Urological Manifestations of Henoch-Schonlein Purpura: A Review

Resolution of sinus bradycardia, high‐grade heart block, and left ventricular systolic dysfunction with rituximab therapy in Henoch‐Schonlein purpura

An adult case of severe steroid-resistant Henoch–Schönlein purpura nephritis treated with intravenous cyclophosphamide and tonsillectomy

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