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Henoch-Schönlein purpura with late-onset necrotising glomerulonephritis - a case report

Joško Mitrović ; Department for Clinical Immunology and Rheumatology, Clinic for Internal Medicine of the School of Medicine, University of Zagreb, Clinical Hospital Dubrava, Zagreb, Croatia
Silva Pukšić ; Department for Clinical Immunology and Rheumatology, Clinic for Internal Medicine of the School of Medicine, University of Zagreb, Clinical Hospital Dubrava, Zagreb, Croatia
Ivica Horvatić ; Department for Nephrology and Dialysis, Clinic for Internal Medicine of the School of Medicine, University of Zagreb, Clinical Hospital Dubrava, Zagreb, Croatia
Vesna Sredoja Tišma ; Cabinet for Dermatovenereology, Clinical Hospital Dubrava, Zagreb, Croatia
Stela Bulimbašić ; Clinical Department for Pathology, Clinical Hospital Dubrava, Zagreb, Croatia
Jadranka Morović-Vergles ; Department for Clinical Immunology and Rheumatology, Clinic for Internal Medicine of the School of Medicine, University of Zagreb, Clinical Hospital Dubrava, Zagreb, Croatia


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Abstract

Henoch-Schönlein purpura (HSP) is the most common systemic vasculitis in children, while it is rare in adults. Typical clinical manifestations include palpable purpura without thrombocytopenia and/or coagulopathy, arthritis/arthralgia, abdominal pain, and/or renal involvement. In adulthood the disease tends to be more serious than in children, with renal manifestations developing over a period of several days to one month after initial symptoms.
In this article we present a 22-year-old female patient with cutaneous vasculitis and arthralgia, in whom renal disease developed 8 weeks after disease onset with microscopic hematuria and proteinuria in urinalysis. Renal biopsy subsequently performed revealed focal necrotising glomerulonephritis with IgA deposits. The patient was treated with high dose methylprednisolone followed by gradual tapering, which induced complete remission of the disease.
In conclusion, patients with HSP should be carefully monitored for systemic involvement, since serious renal disease can develop even as late as two months after disease onset.

Keywords

Henoch-Schönlein purpura; vasculitis; glomerulonephritis

Hrčak ID:

137776

URI

https://hrcak.srce.hr/137776

Publication date:

30.9.2014.

Article data in other languages: croatian

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