J Korean Pediatr Soc.  2003 Oct;46(10):1040-1043.

A Case of Henoch-Schonlein Purpura Nephritis Complicating Encephalopathy Accompanied by Hypertension and Cerebral Vasculitis

• Choi HR
• Kim EJ
• Choi MB
• Lim JY
• Park CH
• Woo HO
• Youn HS

Abstract

Henoch-Shonlein purpura(HSP) is a systemic small-vessel vasculitis that primarily affects the skin, gastrointestinal tract, joints, and kidneys. The nervous system may be involved, less commonly than other organs. When the central nervous system(CNS) was involved, headache, changes in mental status, seizures, and focal neurologic deficits have been reported. Hypertension, uremic encephalopathy, metabolic abnomalities, electrolyte abnormalities, or cerebral vasculitis were suggested as possible causes of the neurologic manifestation. Diagnosis of vasculitic involvement of CNS is difficult. Magnetic resonance imaging of the brain is the modality of choice for the evaluation of the CNS disease. Steroid or plasmapheresis are used in treatment of cerebral vasculitis. We experienced a case of 9-year-old boy who had presented with Henoch-Schonlein purpura nephritis complicating encephalopathy accompanied by hypertension and cerebral vasculitis. Brain MRI showed multiple small nodular-linear pattern enhancing lesions in whole cerebral hemispheres and focal increased T2 signal in the right basal ganglia. We used intravenous immunoglobulin in treatment of cerebral vasculitis. We report this case with a brief review of related literature.

Keyword

Henoch-Schonlein purpura nephritis; Encephalopathy; Hypertension; Cerebral vasculitis; Intravenous immunoglobulin

MeSH Terms

Basal Ganglia
Brain
Brain Diseases, Metabolic
Central Nervous System Diseases
Cerebrum
Child
Diagnosis
Gastrointestinal Tract
Headache
Humans
Hypertension*
Immunoglobulins
Joints
Kidney
Magnetic Resonance Imaging
Male
Nephritis*
Nervous System
Neurologic Manifestations
Plasmapheresis
Purpura, Schoenlein-Henoch*
Seizures
Skin
Vasculitis
Vasculitis, Central Nervous System*
Immunoglobulins