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KMID : 0370920080250010058
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Yeungnam Univercity Journal of Medicine
2008 Volume.25 No. 1 p.58 ~ p.63
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A Case of Adult onset Henoch-Schonlein Purpura with Acute Renal Failure
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Kim Seok-Min
Jang Kyoung-Ae
Do Jun-Young
Park Jong-Won
Yoon Kyung-Woo
Kim Yong-Jin
Park Chan-Seo
Jung Sun-Young
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Abstract
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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.
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KEYWORD
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Henoch-Schonlein Purpura, Acute Renal Failure
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