Korean J Med.  2013 May;84(5):764-768.

Henoch-Schonlein Purpura in a Patient with Ankylosing Spondylitis after Infliximab Therapy

• Jung WJ
• Nam YJ
• Lee SG
• Kim JM
• Song M
• Kim MB
• Kim GT

Abstract

Tumor necrosis factor alpha (TNF-alpha) inhibitors are used widely to treat patients with active rheumatoid arthritis and ankylosing spondylitis (AS). Although various cutaneous reactions can occur as side effects of TNF-alpha inhibitors, systemic vasculitis requiring withdrawal of the agent and immunosuppressive drugs is rare. A 59-year-old male with AS who had been treated with infliximab for 60 months visited us with complaints of palpable purpura on both legs and severe abdominal pain. Abdominal computed tomography showed diffuse wall thickening of the proximal jejunum and ileum and a skin biopsy revealed leukocytoclastic vasculitis. The patient was diagnosed with Henoch-Schonlein purpura (HSP). Infliximab was discontinued and systemic steroid therapy at 0.5 mg/kg resulted in prompt resolution of the HSP. Here, we report the first case of HSP in a patient with AS after infliximab treatment.

Keyword

Ankylosing spondylitis; Henoch-Schonlein purpura; Tumor necrosis factor-alpha inhibitor

MeSH Terms

Abdominal Pain
Antibodies, Monoclonal
Arthritis, Rheumatoid
Biopsy
Humans
Ileum
Jejunum
Leg
Male
Purpura
Purpura, Schoenlein-Henoch
Skin
Spondylitis, Ankylosing
Systemic Vasculitis
Tumor Necrosis Factor-alpha
Vasculitis
Vasculitis, Leukocytoclastic, Cutaneous
Antibodies, Monoclonal
Tumor Necrosis Factor-alpha
Vasculitis, Leukocytoclastic, Cutaneous