Henoch-Schonlein Purpura in Advanced Age: Looking Beyond the Skin
DOI:
https://doi.org/10.24950/rspmi.2022.01.236Keywords:
Adult, Aged, IgA Vasculitis, Renal InsufficiencyAbstract
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.
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Daripally VK, Shah NS. Henoch-Schönlein purpura: a rare vasculitis in older adults.J R Coll Physicians Edinb. 2012;42:124-7.
Kushner, J, Posnick, D, Mones, JM, Ros, A. An unusual case of Henoch- -Schönlein purpura in an elderly male. J Am Osteopathic Coll Dermatol. 2014. 30: 26-8.
Hetland LE, Susrud KS, Lindahl KH, Bygum A. Henoch-Schönlein purpura: a literature review. Acta Derm Venereol. 2017;97:1160-6.
Klair JS, Kaur A, Achanta LM. A rare cause of rash in elderly: diagnostic dilemma. BMJ Case Rep. 2014 ;2014:bcr2014205601. doi: 10.1136/bcr2014-205601.
Soriano A, Galati G, Vespasiani-Gentilucci U, Gallo P, de Vincentis A, Picardi A, Afeltra A. A case of Henoch-Schönlein purpura in the elderly: not just a a second childhood. Aging Clin Exp Res. 2012;24:559-60.
Chowdhury M, Arafat S, Hussain A. Henoch-Schonlein Purpura in an Elderly Women Presenting with Severe GI Bleeding: A case report. J Bangladesh Coll Phys Surg. 2010; 26: 100-2. doi: 10.3329/jbcps.v26i2.4189
Mak SK, Au Sy. Henoch-Schonlein purpura in na elderly lady: A case report and literature review. J Hong Kong Geriatr Soc. 1999; 9:23-8.
Schaier M, Freitag J, Dikow R, Sommerer C, Gross-Weissmann ML, Waldherr R,et al. Henoch-Schönlein purpura in adults is not uncommon in elderly patients with an adverse prognosis. Clin Nephrol. 2011;76:49-56.
Rasmussen C, Tisseyre M, Garon-Czmil J, Atzenhoffer M, Guillevin L, Salem JE,et al. Drug-induced IgA vasculitis in children and adults: Revisiting drug causality using a dual pharmacovigilance-based approach. Autoimmun Rev. 2021; 20:102707.
Lerkvaleekul B, Treepongkaruna S, Saisawat P, Thanachatchairattana P, Angkathunyakul N, Ruangwattanapaisarn N, et al. Henoch-Schönlein purpura from vasculitis to intestinal perforation: A case report and literature review. World J Gastroenterol. 2016;22:6089-94. doi: 10.3748/wjg.v22.i26.6089.
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