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- W2027608222 abstract "A 58 year old male with chronic obstructive lung disease came to the clinic due to confluent purpuric lesions which tended to ulcerate, which began during the days prior on the lower limbs; they increased in number and extended to the buttocks, trunk, upper limbs and face an were accompanied by joint pain of the hands and feet. No other gastrointestinal problems, fever or clinical data suggesting connective tissue disease existed. Upon examination, the patient presented pitting edema of the lower limbs and a universally distributed palpable purpura which did not affect mucosal tissue, with ulcers due to the loss of epidermis on the lower limbs (Figure 1, Figure 2). Laboratory analysis showed: normal urea and creatinine; an erythrocyte sedimentation rate of 95 mm/h; C reactive protein of 5.8 mg/dl; microhematuria; 24 h urine proteins 2,859 mg en orina de 24 h; normal complement and elevated IgA. Autoantibodies were negative. Serology for HBV was compatible with a chronic infection and the viral load was negative. Rheumatoid factor was positive at a low titer and was interpreted as secondary to HBV infection. Skin biopsy was compatible with purpuric leukocytoclastic vasculitis, with an absence of immunofluorescnet deposits. Renal biopsy showed non-hyaline glomeruli and no half moons, with a mild increase in the mesangial matrix and some areas of cellularity, in addition to granular IgA and C3 deposits, detected through immunofluorescence, in the mesangium. Suspecting Schonlein-Henoch purpura (HSP), oral prednisone was started (1 mg/kg/day for 2 weeks, reduced at a rate of 2.5 mg every 14 days, reaching 5 mg per day); losartan, atorvastatine and weekly alendronate plus cholecalcipherol. After one year, the patient has not developed new symptoms and is maintained with low dose steroids, and is being treated with low dose steroid, has good renal function, proteinuria under 500mg/dl and the HBV viral load is still negative. Discussion" @default.
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- W2027608222 date "2010-01-01" @default.
- W2027608222 modified "2023-09-30" @default.
- W2027608222 title "Schönlein-Henoch purpura: a case observation" @default.
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- W2027608222 doi "https://doi.org/10.1016/s2173-5743(10)70050-2" @default.
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