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Yeungnam Univ J Med > Volume 25(1); 2008 > Article
Yeungnam University Journal of Medicine 2008;25(1):58-63.
DOI:    Published online June 30, 2008.
A Case of Adult onset Henoch-Sch?nlein Purpura with Acute Renal Failure.
Seok Min Kim, Kyung Ae Chang, Sun Young Jung, Chan Soh Park, Jong Won Park, Jun Young Do, Yong Jin Kim, Kyung Woo Yoon
1Department of Internal Medicine, College of Medicine, Yeungnam University, Daegu, Korea.
2Department of Pathology, College of Medicine, Yeungnam University, Daegu, Korea.
Henoch-Schonlein purpura (HSP) is a leukocytoclastic vasculitis of small vessels with deposition of IgA, commonly resulting in skin, joint, gastrointestinal, and kidney involvement. HSP is an uncommon disorder in adults and accounts for 0.6% to 2% of adult nephropathy. We report a case of HSP with acute renal failure successfully treated with corticosteroid. In this case, the patient presented with vasculitic purpuric rash on lower extremity, arthralgia in the wrist, abdominal pain, hematochezia, oliguria and azotemia. Abdominal CT showed wall thickening of the small and large bowels. Skin biopsy revealed leukocytoclastic vasculitis. Percutaneous renal biopsy showed no crescent formation, but mesangial IgA and C3 deposits were observed by immunofluorescence. The patient was treated with corticosteroid (1mg/kg per day) and hemodialysis. After treatment, renal function improved and purpuric lesion, arthralgia and abdominal pain disappeared. Thus, when adults present with purpuric rash and rapidly progressive glomerulonephritis (RPGN), HSP should be a diagnostic consideration.
Key Words: Henoch-Schonlein Purpura, Acute Renal Failure


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