J Rheum Dis.  2011 Dec;18(4):292-296. 10.4078/jrd.2011.18.4.292.

A Case of Henoch-Schonlein Purpura Complicated by Acute Pancreatitis and Interstitial Pneumonitis

Affiliations
  • 1Division of Rheumatology, Division of Gastroenterology, Department of Internal Medicine, Busan Medical Center, Busan, Korea. jiny0122a@daum.net
  • 2Department of Pathology, Busan Medical Center, Busan, Korea.

Abstract

Henoch-Schonlein purpura (HSP) is a systemic vasculitis involving the skin, gut, joint and kidney that is characterized by immunoglobulin A (IgA)-dominant immune deposits in target organs. Gastrointestinal involvement is known to be relatively common, but acute pancreatitis and pulmonary involvement are rare in Henoch-Schonlein purpura. We experienced a case of a 46-year-old man who developed adult-onset HSP complicated by acute pancreatitis and interstitial pneumonitis. The patient received corticosteroid therapy at a dosage of 0.5 mg/kg. After corticosteroid therapy, patient's symptoms improved. We report here the first case of HSP complicated by acute pancreatitis and interstitial pneumonitis.

Keyword

Henoch-Schonlein purpura; Pancreatitis; Pneumonitis

MeSH Terms

Humans
Immunoglobulin A
Joints
Kidney
Lung Diseases, Interstitial
Middle Aged
Pancreatitis
Pneumonia
Purpura, Schoenlein-Henoch
Skin
Systemic Vasculitis
Immunoglobulin A

Figure

  • Figure 1. (A) Chest X-ray shows consolidation in the left upper lobe (LUL) on admission (arrow). (B) Chest CT shows focal ground- glass opacity in the LUL (arrow).

  • Figure 2. (A) Abdomen CT shows diffuse and multi-loculated wall thickening of the small bowel (espe-cially the terminal ileum and ileum), on the first hospital day. (B) Abdomen CT shows fluid-filled bowel loops without wall thickening of the small bowel, on the third hospital day. (C) Abdomen CT shows diffuse wall thickening of the small bowel with fluid-filled bowel loops, on the seventh hospital day. (D) Colo-noscopy shows diffuse hyperemic edematous mucosa and erosions in the terminal ileum.

  • Figure 3. Skin biopsy shows leukocytoclastic vasculitis with perivascular infiltration of neutrophils (H&E stain ×200).

  • Figure 4. The serum amylase and lipase results.

  • Figure 5. Chest X-ray shows improved state of LUL lesion after treatment (arrow) with steroids.


Reference

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