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Case Reports
. 2017 Jun;49(2):146-150.
doi: 10.3947/ic.2017.49.2.146. Epub 2017 Feb 7.

Henoch-Schönlein Purpura with Concurrent Cytomegalovirus Duodenitis

Sae Bom Shin  1 , Yeong Jin Choi  2 , Jieun Lee  3 , Bong Gye Kwak  1 , Yong Hee Kim  1 , Kyung Sun Ha  1 , Jin Hyoung Kang  4
Affiliations
Case Reports

Henoch-Schönlein Purpura with Concurrent Cytomegalovirus Duodenitis

Sae Bom Shin et al. Infect Chemother. 2017 Jun.

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.

Keywords: Cytomegalovirus; Henoch-Schönlein purpura; Small-cell lung cancer.

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Conflict of interest statement

No conflicts of interest.

Figures

Figure 1
Figure 1
Skin lesions on the lower extremities: multiple purpura were observed on both legs (A), and abdomen (B).
Figure 2
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).
Figure 3
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.
See this image and copyright information in PMC

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