Korean J Intern Med.  2002 Dec;17(4):270-273.

A Case of Refractory Henoch-Sch nlein Purpura Treated with Thalidomide

• Choi SJ
• Park SK
• Uhm WS
• Hong DS
• Park HS
• Park YL
• Kwon KW

Abstract

Henoch-Sch nlein purpura is an acute, self-limited vasculitis syndrome which shows characteristic skin, joint, renal and gastrointestinal manifestations. It is common in childhood and may also occur in adults with fatal complications such as nephritis and gastrointestinal bleeding. We experienced a case of a 20-year-old woman who presented with palpable purpura and severe arthritis. The histopathologic examination of the skin revealed leukocytoclastic vasculitis with perivascular deposition of IgA and she was diagnosed with Henoch-Sch nlein purpura. Despite treatment with prednisolone for one month, she had more aggravated purpura and fatal gastrointestinal bleeding. The symptoms were improved shortly by cyclophosphamide pulse therapy with plasmapheresis but symptoms were aggravated and symmetric mononeuropathy of the ulnar nerve developed. She was treated with 400 mg/day of thalidomide and symptoms were improved. We herein report a case of Henoch-Sch nlein purpura successfully treated with thalidomide which was refractory to prednisolone, immunosuppressive drugs and plasmapheresis.

Keyword

Henoch-Sch nlein purpura; Thalidomide

MeSH Terms

Adult
Dermatologic Agents/*therapeutic use
Female
Human
Purpura, Schoenlein-Henoch/*drug therapy
Thalidomide/*therapeutic use