BMC Research Notes (Jan 2013)

An adult patient with Henoch-Schönlein purpura and non-occlusive mesenteric ischemia

  • Oshikata Chiyako,
  • Tsurikisawa Naomi,
  • Takigawa Masakazu,
  • Omori Tomoko,
  • Sugano Satoshi,
  • Tsuburai Takahiro,
  • Mitomi Hiroyuki,
  • Takemura Tamiko,
  • Akiyama Kazuo

DOI
https://doi.org/10.1186/1756-0500-6-26
Journal volume & issue
Vol. 6, no. 1
p. 26

Abstract

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Abstract Background Onset of Henoch-Schönlein purpura (HSP) in middle age is uncommon, and adults with renal or gastrointestinal involvement present with more severe disease than do similar pediatric patients. Case presentation We present the case of a 69-year-old male with HSP who, after treatment with steroids, cyclophosphamide, and continuous intravenous prostaglandin E1 (PGE1), died as a result of severe gastrointestinal involvement with non-occlusive mesenteric ischemia (NOMI). Vascular narrowing associated with the NOMI improved after catheter injection of PGE1 and prednisolone, but the patient died of bleeding from an exposed small vessel. At autopsy there was no active vasculitis in the jejunal submucosa. Conclusion Treatment with PGE1 and prednisolone might improve small-vessel vasculitis associated with NOMI.

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