Infect Chemother.  2017 Jun;49(2):146-150. 10.3947/ic.2017.49.2.146.

Henoch-Schönlein Purpura with Concurrent Cytomegalovirus Duodenitis

• Shin SB
• Choi YJ
• Lee J
• Kwak B
• Kim YH
• Ha KS
• Kang JH

• KMID: 2383938
• DOI: http://doi.org/10.3947/ic.2017.49.2.146

Abstract

Henoch-Schönlein purpura (HSP) is a systemic vasculitis involving the small vessels with distinct clinical features. The etiology of HSP is diverse, and viral infection is one of the many predisposing factors. Cytomegalovirus (CMV) infection mostly affects immune-suppressed patients, but rarely patients with normal immunity can also be affected. Authors experienced a case of HSP patient, with underlying small-cell lung cancer (SCLC) with CMV duodenitis. This is a rare case of HSP diagnosed in SCLC patient with predisposing factor of CMV infection.

Keyword

Henoch-Schönlein purpura; Cytomegalovirus; Small-cell lung cancer

MeSH Terms

Causality
Cytomegalovirus*
Duodenitis*
Humans
Lung Neoplasms
Purpura*
Systemic Vasculitis

Figure

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  Figure 1 Skin lesions on the lower extremities: multiple purpura were observed on both legs (A), and abdomen (B).

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  Figure 2 Abdominal computed tomography revealed diffuse edematous thickening of the duodenum to proximal jejunum with prominent mucosal enhancement (A). Upper gastrointestinal endoscopy showed multiple ulceration of duodenal mucosa (B). Histopathological examination of duodenal ulcers revealed hyperchromatic increased large nuclei of glandular epithelium (C) and cytomegalovirus inclusion bodies (D, arrow).

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  Figure 3 Schematic presentation of the patient’s clinical course. MTX, methotrexate; HCQ, Hydroxychloroquine sulfate; IVGV, intravenous immunoglobulin; CMV, cytomegalovirus; PCR, polymerase chain reaction; CT, computed tomography; F/U, follow-up; CTx, chemotherapy; RTX, radiation therapy.

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