Henoch-Schonlein Purpura in Advanced Age: Looking Beyond the Skin

Abstract

Henoch-Schonlein purpura (HSP) is a subtype of small vessel cutaneous vasculitis that is characterized by the deposition of IgA in the vessel walls, which causes palpable petechial/purpuric lesions, non-thrombocytopenic, typically in the lower extremities. Clinically it is manifested by the tetrad: palpable purpura, arthritis/arthralgias, abdominal complaints and kidney injury. Although the pathophysiology is not yet fully understood, infections, medications and neoplasia have been suggested as triggers. Morbidity is related to the progression to chronic kidney disease. PHS is very common in children but rare in adults and the elderly. For this reason, we present two cases of HSP in two patients over 60 years old, with renal and intestinal injury. Because renal involvement and failure is most common in this population (when compared to children), it ismportant to consider this diagnosis in the adult population due to its important morbidity and mortality.