Fatal Henoch-Schonlein Purpura in an Adult With Dieulafoy Lesions

被引:4
作者
Cristescu, Dan A. [1 ]
Yuvienco, Candice [2 ]
Schwartz, Stuart [2 ]
机构
[1] Boston Univ, Div Rheumatol, Roger Williams Med Ctr, Boston, MA 02215 USA
[2] Brown Univ, Rhode Isl Hosp, Div Rheumatol, Providence, RI 02903 USA
关键词
Henoch-Schonlein purpura; vasculitis; Dieulafoy lesion; gastrointestinal hemorrhage; adult; NEPHRITIS; CHILDHOOD; CYCLOPHOSPHAMIDE; PLASMAPHERESIS; CHILDREN; DISEASE;
D O I
10.1097/RHU.0b013e318262e3f9
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Henoch-Schonlein purpura (HSP) is considered a benign disease of children. We report a severe case of HSP in an adult causing renal failure and gastrointestinal (GI) hemorrhage. Despite aggressive treatment with corticosteroids, cyclophosphamide, and plasmapheresis, the patient developed massive GI bleeding from 2 Dieulafoy lesions and died weeks after bowel resection. Although uncommon, when massive GI hemorrhage occurs, actively bleeding Dieulafoy lesions, although uncommon, should be suspected and evaluated early.
引用
收藏
页码:253 / 256
页数:4
相关论文
共 12 条
[1]   Henoch-Schonlein purpura in adulthood and childhood - Two different expressions of the same syndrome [J].
Blanco, R ;
MartinezTaboada, VM ;
RodriguezValverde, V ;
GarciaFuentes, M ;
GonzalezGay, MA .
ARTHRITIS AND RHEUMATISM, 1997, 40 (05) :859-864
[2]   Incidence of Henoch-Schonlein purpura, Kawasaki disease, and rare vasculitides in children of different ethnic origins [J].
Gardner-Medwin, JMM ;
Dolezalova, P ;
Cummins, C ;
Southwood, TR .
LANCET, 2002, 360 (9341) :1197-1202
[3]   Plasmapheresis as the sole therapy for rapidly progressive Henoch-Schonlein purpura nephritis in children [J].
Hattori, M ;
Ito, K ;
Konomoto, T ;
Kawaguchi, H ;
Yoshioka, T ;
Khono, M .
AMERICAN JOURNAL OF KIDNEY DISEASES, 1999, 33 (03) :427-433
[4]  
Levy M, 1976, Adv Nephrol Necker Hosp, V6, P183
[5]  
Meiller MJL, 2008, CLINICS, V63, P273
[6]   Henoch-Schonlein Purpura in adults: Outcome and prognostic factors [J].
Pillebout, E ;
Thervet, E ;
Hill, G ;
Alberti, C ;
Vanhille, P ;
Nochy, D .
JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 2002, 13 (05) :1271-1278
[7]   Addition of cyclophosphamide to steroids provides no benefit compared with steroids alone in treating adult patients with severe Henoch Schonlein Purpura [J].
Pillebout, Evangeline ;
Alberti, Corinne ;
Guillevin, Loic ;
Ouslimani, Amel ;
Thervet, Eric .
KIDNEY INTERNATIONAL, 2010, 78 (05) :495-502
[8]   Treating severe Henoch-Schonlein and IgA nephritis with plasmapheresis alone [J].
Shenoy, Mohan ;
Ognjanovic, Milos V. ;
Coulthard, Malcolm G. .
PEDIATRIC NEPHROLOGY, 2007, 22 (08) :1167-1171
[9]   Henoch-Schonlein purpura nephritis: course of disease and efficacy of cyclophosphamide [J].
Tarshish, P ;
Bernstein, J ;
Edelmann, CM .
PEDIATRIC NEPHROLOGY, 2004, 19 (01) :51-56
[10]   Henoch schonlein purpura in childhood: Epidemiological and clinical analysis of 150 cases over a 5-year period and review of literature [J].
Trapani, S ;
Micheli, A ;
Grisolia, F ;
Resti, M ;
Chiappini, E ;
Falcini, F ;
De Martino, M .
SEMINARS IN ARTHRITIS AND RHEUMATISM, 2005, 35 (03) :143-153