North American Journal of Medical Sciences

CASE REPORT
Year
: 2014  |  Volume : 6  |  Issue : 10  |  Page : 543--544

An unusual presentation of childhood vasculitis presenting in adulthood: A challenging diagnosis of Henoch-Schönlein Purpura


Charat Thongprayoon1, Wisit Cheungpasitporn2, Natanong Thamcharoen3, Jackrapong Bruminhent1 
1 Mayo Clinic, Rochester, Minnesota, USA
2 Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota, USA
3 Bassett Medical Center, Cooperstown, New York, USA

Correspondence Address:
Wisit Cheungpasitporn
Mayo Clinic, Rochester, Minnesota-55905
USA

Context: Henoch-Schφnlein purpura (HSP), a systemic IgA vascultitis, is uncommon in adults, with an incidence rate of 0.1 to 1.2 per million in adults over 20 years old. This vasculitic syndrome can present as an uncommon cause of intestinal obstruction in older patients. We report a case of an older woman with HSP presenting with small bowel obstruction and vasculitic rash. Case Report: We report a 67-year-old woman who presented with small bowel obstruction and skin rash. Skin biopsy revealed leukocytoclastic vasculitis with +IgA granular deposition within the walls of superficial dermal vessels. Kidney biopsy confirmed the diagnosis of HSP with mild mesangial proliferative IgA nephropathy. Her abdominal pain and small bowel obstruction were improved with conservative treatment. She continued to do well with normal kidney function at a 3-month follow-up visit. Conclusion: HSP, a systemic IgA vasculitis, is a predominantly pediatric vasculitis and is uncommon in adults. In adults, the disease process is identical to that in children. However, gastrointestinal manifestation is less common in older patients, and bowel perforation and obstruction are rare. Intestinal obstruction with skin rash and renal involvement should raise suspicions of HSP.


How to cite this article:
Thongprayoon C, Cheungpasitporn W, Thamcharoen N, Bruminhent J. An unusual presentation of childhood vasculitis presenting in adulthood: A challenging diagnosis of Henoch-Schönlein Purpura.North Am J Med Sci 2014;6:543-544


How to cite this URL:
Thongprayoon C, Cheungpasitporn W, Thamcharoen N, Bruminhent J. An unusual presentation of childhood vasculitis presenting in adulthood: A challenging diagnosis of Henoch-Schönlein Purpura. North Am J Med Sci [serial online] 2014 [cited 2020 Aug 7 ];6:543-544
Available from: http://www.najms.org/article.asp?issn=1947-2714;year=2014;volume=6;issue=10;spage=543;epage=544;aulast=Thongprayoon;type=0