Yeungnam Univ J Med.  2008 Jun;25(1):58-63.

A Case of Adult onset Henoch-Sch?nlein Purpura with Acute Renal Failure

• Kim SM
• Chang KA
• Jung SY
• Park CS
• Park JW
• Do JY
• Kim YJ
• Yoon KW

Abstract

Henoch-Schonlein purpura (HSP) is a leukocytoclastic vasculitis of small vessels with deposition of IgA, commonly resulting in skin, joint, gastrointestinal, and kidney involvement. HSP is an uncommon disorder in adults and accounts for 0.6% to 2% of adult nephropathy. We report a case of HSP with acute renal failure successfully treated with corticosteroid. In this case, the patient presented with vasculitic purpuric rash on lower extremity, arthralgia in the wrist, abdominal pain, hematochezia, oliguria and azotemia. Abdominal CT showed wall thickening of the small and large bowels. Skin biopsy revealed leukocytoclastic vasculitis. Percutaneous renal biopsy showed no crescent formation, but mesangial IgA and C3 deposits were observed by immunofluorescence. The patient was treated with corticosteroid (1mg/kg per day) and hemodialysis. After treatment, renal function improved and purpuric lesion, arthralgia and abdominal pain disappeared. Thus, when adults present with purpuric rash and rapidly progressive glomerulonephritis (RPGN), HSP should be a diagnostic consideration.

Keyword

Henoch-Schonlein Purpura; Acute Renal Failure

MeSH Terms

Abdominal Pain
Acute Kidney Injury
Adult
Arthralgia
Azotemia
Biopsy
Exanthema
Fluorescent Antibody Technique
Gastrointestinal Hemorrhage
Glomerulonephritis
Humans
Immunoglobulin A
Joints
Kidney
Lower Extremity
Oliguria
Purpura
Purpura, Schoenlein-Henoch
Renal Dialysis
Skin
Vasculitis
Vasculitis, Leukocytoclastic, Cutaneous
Wrist
Immunoglobulin A
Vasculitis, Leukocytoclastic, Cutaneous