Open AccessSeizures, renal failure and acute respiratory failure: not your typical case of Henoch-Schonlein purpura
Author(s) -
Subhasish Bose,
Samata Pathireddy,
Krishna M. Baradhi,
Narothama Reddy Aeddula
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2019-229939
Subject(s) - medicine , purpura (gastropod) , henoch schonlein purpura , rash , respiratory failure , abdominal pain , renal biopsy , vasculitis , dialysis , respiratory system , biopsy , dermatology , surgery , disease , ecology , biology
A 30-year-old Caucasian woman with no prior medical history presented with pedal oedema, arthralgias and abdominal pain with diarrhoea, following a respiratory infection. She had mild abdominal tenderness along with a purpuric rash on the extremities and was anaemic. Following initial workup for anaemia and rash, her condition deteriorated with renal impairment, respiratory failure and seizures necessitating ventilatory support, dialysis and steroids. Serologies were negative, and skin biopsy showed leucocytoclastic vasculitis without vascular IgA deposition, and renal biopsy showed subendothelial, mesangial deposits of IgA with C3 indicative of Henoch-Schonlein purpura (HSP). She was treated with steroids, haemodialysis and on 6-month follow-up recovered renal function. We present the case to illustrate that HSP, though rare in adults, can present with multiorgan failure, with renal, pulmonary and central nervous system involvement, and the need for early diagnosis and prompt treatment for rapid clinical recovery.