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KMID : 0338420020170040270
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The Korean Journal of Internal Medicine
2002 Volume.17 No. 4 p.270 ~ p.273
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A Case of Refractory Henoch-Schonlein Purpura Treated with Thalidomide
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Sung Kyu Park/Soo Jeong Choi
Sung Kyu Park/Wan Sik Uhm/Dae Sik Hong/Hee Sook Park/Young Lip Park*/Kye Won Kwon†
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Abstract
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Henoch-Schonlein 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-Schonlein 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-Schonlein purpura successfully treated with thalidomide which was refractory to prednisolone, immunosuppressive drugs and plasmapheresis.
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KEYWORD
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Henoch-Schonlein purpura, Thalidomide,
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