Henoch Schönlein Purpura in Pregnancy: a Case with Uncomplicated Maternal and Neonatal Outcome

Introduction: Henoch-Schonlein Purpura or Immunoglobulin-A vasculitis is a systemic vasculitis caused by immune complexes that attack small blood vessels. The classic symptoms of Henoch-Schonlein Purpura include erythema purpura, arthralgia, gastrointestinal complaints, and renal involvement. Some cases show that pregnancy itself could be the trigger for its recurrence and lead to early delivery. Case report: A 33-year-old patient, G2P1A0 and 35 weeks and 4 days pregnant complained of diarrhea 8 days before hospital admission (8-15 times per day). The patient was diagnosed with Henoch-Schonlein Purpura 3 years ago. Upon monitoring in the ward, the fetus was found to be in a compromised condition and an emergency cesarean section was needed. The patient was assessed as having an ASA II physical status and was anesthetized with regional anesthesia epidural in the sitting position, with a median approach, puncture at L3-L4 level, and with 12 ml of Bupivacaine 0.5% isobaric. Postoperative care was continued in the ward. Discussion: As long as there are no contraindications, a neuraxial block could be performed on parturient patients with Henoch-Schonlein Purpura who would undergo a cesarean section. Neuraxial block, namely epidural block, has the added advantage of being a postoperative analgesic and helps to avoid the use of Non-Steroidal Anti Inflammatory Drugs (NSAIDs) in Henoch-Schonlein Purpura patients who often have renal complications. Conclusion: Caesarean Section with Henoch-Schonlein Purpura disease has been reported with Epidural Block Anesthesia without complications.

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Anaesthetic Management of Henoch Scholein Purpura in Adult With Acute Abdomen – A Case Report

Anusha¹

2022

IJAR

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Henoch-Schonlein Purpura (HSP) is a small vessel vasculitis mediated by IgA-immune complex deposition. It is characterized by non-thrombocytopenic purpura, arthritis or arthralgia, abdominal pain, and nephropathy. HSP has an overall excellent prognosis in children, but very rarely reported in adult. There are hardly any evidence for the anesthetic management of adult patients with HSP. We report a sucessful management of a case of a young adult with HSP who presented with acute abdomen for laparotomy. A 25yr old male with HSP presented with acute abdomen two days after admission. Under general anaesthesia with epidural anagesia, emergency laparotomy and resection anastomosis was done. Patient was stable post op and discharged on 5th post operative day. Bowel ischaemia secondary to HSP is a very rare complication. Monitoring and frequent reassessment with early surgical intervention helps to reduce morbidity, and improves outcome. Epidural analgesia can be safely administered in a patient with HSP as it avoids the use of non steroidal anti inammatory drugs for post operative analgesia.

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Henoch Schönlein Purpura in Pregnancy: a Case with Uncomplicated Maternal and Neonatal Outcome

Cited by 3 publications

References 19 publications

Henoch–Schonlein Purpura

Henoch–Schonlein Purpura

Anesthetic Management of A Patient with Henoch-Schonlein Purpura for Caesarean Section

Anaesthetic Management of Henoch Scholein Purpura in Adult With Acute Abdomen – A Case Report

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