KMID : 0882420070730040453
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Korean Journal of Medicine 2007 Volume.73 No. 4 p.453 ~ p.456
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A case of henoch-Schonlein purpura complicated by hemorrhagic gastroenteritis and IgA nephropathy in a patient suffering with juvenile rheumatoid arthritis
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Shin Joon-Beom
Lee Yeon-Ah Noon Soo-Young Woo Doo-Hyun Lee Sang-Hoon Hong Seung-Jae Yang Hyung-In
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Abstract
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Henoch-Schonlein purpura (HSP) is a systemic vasculitis with IgA dominant immune complex deposits that affect the
small vessels in the skin, joints, gastrointestinal tract and kidneys. Gastrointestinal symptoms are common and the
manifestations include abdominal pain, bleeding, bowel infarction, intussusceptions or even perforation. Polyarticular onset
juvenile rheumatoid arthritis (JRA) is a rare form of arthritis that affects children and young adults. The relationship
between HSP and JRA is uncertain. We report on a 24-year-old man with a history of polyarticular onset JRA and HSP
that was complicated by hemorrhagic gastroenteritis. The gastroscopy and colonoscopic findings showed extensive
hemorrhagic inflammatory changes of the gastric and intestinal mucosa. The patient had severe bloody diarrheal
symptoms, abdominal pain and gross hematuria. The 24 hours urine chemistry profile showed the proteinuria was greater
than 4.5 g/day, and immunofluorescent staining of the renal biopsy specimen showed diffuse granular mesangial deposits
of IgA and C3. The abdominal manifestations and proteinuria were improved after methylprednisolone therapy
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KEYWORD
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Henoch-Schonlein purpura, Polyarticular onset juvenile rheumatoid arthritis, Hemorrhagic gastritis, Hemorrhagic colitis, IgA nephropathy
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