Successful treatment with leukocytapheresis in refractory Henoch-Schonlein purpura: case report

A Japanese boy aged 7 years referred to our hospital because of steroid-resistant colicky abdominal pain and purpuric rash due to Henoch-Schonlein purpura (HSP). Since 2 weeks ago, he had been suffering from generalized purpuric rash and colicky abdominal pain associated with bloody diarrhea. The diagnosis was HSP. Although he had been treated with oral prednisolone and repeated intravenous coagulation factor XIII administration, the purpuric rash and colicky abdominal pain persisted. Because of steroid-resistant and refractory clinical pictures, leukocytapheresis (LCAP) using a granulocyte removal column was initiated thereafter. Following 3 times of treatment, his clinical symptoms completely disappeared and the increased levels of serum interleukin-6 were decreased to within the normal ranges. No adverse reaction was observed. These clinical observations suggested that LCAP might be beneficial to a proportion of patients with severe HSP. This is the first report to describe efficacy of LCAP in severe HSP.