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Unusual presentation of more common disease/injury
CASE REPORT
Seizures, renal failure and acute respiratory failure: not your typical case of Henoch-Schonlein purpura
  1. Subhasish Bose1,
  2. Samata Pathireddy2,
  3. Krishna M Baradhi3 and
  4. Narothama Reddy Aeddula4,5
  1. 1 Department of Nephrology, Lynchburg Nephrology, Lynchburg, Virginia, USA
  2. 2 Department of Internal Medicine, Deaconess Health System, Evansville, Indiana, USA
  3. 3 Department of Nephrology, University of Oklahoma School of Community Medicine, Tulsa, Oklahoma, USA
  4. 4 Department of Medicine, Deaconess Health System, Evansville, Indiana, USA
  5. 5 Department of Medicine, Indiana University School of Medicine, Evansville, Indiana, USA
  1. Correspondence to Dr Samata Pathireddy, drspathireddy{at}gmail.com

Abstract

A 30-year-old Caucasian woman with no prior medical history presented with pedal oedema, arthralgias and abdominal pain with diarrhoea, following a respiratory infection. She had mild abdominal tenderness along with a purpuric rash on the extremities and was anaemic. Following initial workup for anaemia and rash, her condition deteriorated with renal impairment, respiratory failure and seizures necessitating ventilatory support, dialysis and steroids. Serologies were negative, and skin biopsy showed leucocytoclastic vasculitis without vascular IgA deposition, and renal biopsy showed subendothelial, mesangial deposits of IgA with C3 indicative of Henoch-Schonlein purpura (HSP). She was treated with steroids, haemodialysis and on 6-month follow-up recovered renal function. We present the case to illustrate that HSP, though rare in adults, can present with multiorgan failure, with renal, pulmonary and central nervous system involvement, and the need for early diagnosis and prompt treatment for rapid clinical recovery.

  • GI bleeding
  • haematology (incl blood transfusion)
  • adult intensive care
  • acute renal failure
  • mechanical ventilation

https://doi.org/10.1136/bcr-2019-229939

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    Footnotes

    • Contributors SB performed the planning, conception, patient consent and acquisition of data. SB and NRA helped with the final drafting of the case report. SB, SP, KMB and NRA were involved in the final preparation of the manuscript and review. SP and NRA are the first authors and have equally contributed to the majority of the article.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Patient consent for publication Obtained.