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Case Reports
. 2002 Dec;17(4):270-3.
doi: 10.3904/kjim.2002.17.4.270.

A case of refractory Henoch-Schönlein purpura treated with thalidomide

Soo Jeong Choi  1 , Sung Kyu Park, Wan Sik Uhm, Dae Sik Hong, Hee Sook Park, Young Lip Park, Kye Won Kwon
Affiliations
Case Reports

A case of refractory Henoch-Schönlein purpura treated with thalidomide

Soo Jeong Choi et al. Korean J Intern Med. 2002 Dec.

Abstract

Henoch-Schönlein purpura is an acute, self-limited vasculitis syndrome which shows characteristic skin, joint, renal and gastrointestinal manifestations. It is common in childhood and may also occur in adults with fatal complications such as nephritis and gastrointestinal bleeding. We experienced a case of a 20-year-old woman who presented with palpable purpura and severe arthritis. The histopathologic examination of the skin revealed leukocytoclastic vasculitis with perivascular deposition of IgA and she was diagnosed with Henoch-Schönlein purpura. Despite treatment with prednisolone for one month, she had more aggravated purpura and fatal gastrointestinal bleeding. The symptoms were improved shortly by cyclophosphamide pulse therapy with plasmapheresis but symptoms were aggravated and symmetric mononeuropathy of the ulnar nerve developed. She was treated with 400 mg/day of thalidomide and symptoms were improved. We herein report a case of Henoch-Schönlein purpura successfully treated with thalidomide which was refractory to prednisolone, immunosuppressive drugs and plasmapheresis.

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Figures

Figure 1.
Figure 1.
Palpable purpura on the foot.
Figure 2.
Figure 2.
(A) Skin biopsy shows necrotizing leukocytoclastic vasculitis (H&E, ×200). (B) Immunofluorescent examination shows IgA deposition on the wall of vessel.
Figure 3.
Figure 3.
Colonoscopic findings show multiple ulcers with hemorrhage.
Figure 4.
Figure 4.
Colon biopsy shows neutrophils and nuclear debris infiltration on the wall of vessels (H&E, ×400).
Figure 5.
Figure 5.
Improved purpura with pigmentation.
See this image and copyright information in PMC

References

    1. Saulbury FT. Henoch-Schönlein purpura. Curr Opin Rheumatol. 2001;13:35–40. - PubMed
    1. Moraes M, Russo G. Thalidomide and its dermatoiogic uses. Am J Med Sci. 2001;321:321–326. - PubMed
    1. Meierhofer C, Dunzendorfer S, Wiedemann CJ. Theoretical basis for the activity of thalidomide. Biodrugs. 2001;15:681–703. - PubMed
    1. Egan CA, Taylor TB, Meyer LJ, Petersen MJ, Zone JJ. IgA1 is the major IgA subclass in cutaneous blood vessels in Henoch-Schönlein purpura. Br J Dermatol. 1999;141:859–862. - PubMed
    1. Blanco R, Martinez-Taboada VM, Rodriguez-Valverde V, Garcia-Fluentes M, Gonzalez-Gay MA. Henoch-Schönlein purpura in adulthood and childhood; two different expressions of the same syndrome. Arthritis Rheum. 1997;40:859–864. - PubMed

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