Fatal Henoch-Schönlein purpura in an adult with Dieulafoy lesions

J Clin Rheumatol. 2012 Aug;18(5):253-6. doi: 10.1097/RHU.0b013e318262e3f9.

Abstract

Henoch-Schönlein purpura (HSP) is considered a benign disease of children. We report a severe case of HSP in an adult causing renal failure and gastrointestinal (GI) hemorrhage. Despite aggressive treatment with corticosteroids, cyclophosphamide, and plasmapheresis, the patient developed massive GI bleeding from 2 Dieulafoy lesions and died weeks after bowel resection. Although uncommon, when massive GI hemorrhage occurs, actively bleeding Dieulafoy lesions, although uncommon, should be suspected and evaluated early.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Angioscopy
  • Antirheumatic Agents / administration & dosage
  • Biopsy
  • Colonoscopy
  • Combined Modality Therapy
  • Cyclophosphamide / administration & dosage
  • Fatal Outcome
  • Gastrointestinal Hemorrhage / diagnosis
  • Gastrointestinal Hemorrhage / etiology*
  • Gastrointestinal Hemorrhage / therapy
  • Glucocorticoids / administration & dosage
  • Humans
  • IgA Vasculitis / diagnosis
  • IgA Vasculitis / etiology*
  • IgA Vasculitis / therapy
  • Ileum / blood supply*
  • Intestinal Mucosa / blood supply
  • Jejunum / blood supply*
  • Male
  • Mesenteric Artery, Superior / abnormalities*
  • Plasmapheresis
  • Tomography, X-Ray Computed

Substances

  • Antirheumatic Agents
  • Glucocorticoids
  • Cyclophosphamide