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Case Reports
. 2018 Feb 15;28(1):010801.
doi: 10.11613/BM.2018.010801. Epub 2018 Jan 10.

Henoch-Schönlein purpura in the third trimester of pregnancy

Ivka Djakovic  1 , Drazan Butorac  1 , Zeljko Vucicevic  2 , Vesna Kosec  1 , Andrea Tesija Kuna  3 , Liborija Lugović-Mihić  4
Affiliations
Case Reports

Henoch-Schönlein purpura in the third trimester of pregnancy

Ivka Djakovic et al. Biochem Med (Zagreb). .

Abstract

Henoch-Schönlein purpura (HSP) is an IgA-mediated small vessels' vasculitis that affects the skin, intestines and kidneys. Pregnancy has been reported as an exacerbating factor. We present the case of a 24-year-old primigravida with HSP that occurred in the third trimester and lasted up to the end of the successful delivery. She had pruritic maculopapular exanthema on her legs. Biopsy of a cutaneous lesion was performed for histopathologic features and direct immunofluorescence (DIF) for the presence of perivascular IgA deposition. Histopathology of the cutaneous lesion confirmed leukocytoclastic vasculitis. A DIF examination of the skin lesion confirmed deposits of fibrinogen in the small blood vessel walls. Six weeks following delivery, the skin lesions almost completely disappeared. Control laboratory findings were normal. This case of HSP might have been primarily associated with a preceding respiratory infection but this should first be carefully investigated due to a possible severe immunological disease in the patient's background requiring special attention since nephrotic symptoms may occur.

Keywords: Henoch-Schönlein purpura; glomerulonephritis; leukocytoclastic vasculitis; preeclampsia; pregnancy.

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Conflict of interest statement

Potential conflict of interest: None declared.

Figures

Figure 1
Figure 1
Purpuric lesions of the patient’s shins
See this image and copyright information in PMC

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