A case of refractory Henoch-Schönlein purpura treated with thalidomide.

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.

• Authors: Soo Jeong Choi, Sung Kyu Park, Wan Sik Uhm, Dae Sik Hong, Hee Sook Park, Young Lip Park, Kye Won Kwon
• Journal: The Korean journal of internal medicine (Korean J Intern Med) Vol. 17 Issue 4 Pg. 270-3 (Dec 2002) ISSN: 1226-3303 [Print] Korea (South)
• PMID: 12647645 (Publication Type: Case Reports, Journal Article)

Chemical References

• Dermatologic Agents
• Thalidomide

Topics

• Adult
• Dermatologic Agents (therapeutic use)
• Female
• Humans
• IgA Vasculitis (drug therapy)
• Thalidomide (therapeutic use)