Henoch-Schönlein purpura associated with pregnancy in a patient with chronic thyroiditis.
A case of Henoch-Schönlein purpura with chronic thyroiditis associated with pregnancy is reported. A 27-year-old woman had a struma since age 14. She felt easily fatigable along with enlargement of the struma after the delivery of her first child, and was diagnosed as having chronic thyroiditis. She developed hematuria between the first delivery and the second pregnancy. The hematuria continued during the second pregnancy and in the postpartum period. Immediately after the delivery of her second child, she developed purpura followed by arthralgia and melena. Renal biopsy revealed focal segmental and global type Henoch-Schönlein nephritis. We reviewed five cases of Henoch-Schönlein purpura associated with pregnancy and found that our case is the first in which purpura developed immediately after delivery. Our patient would have developed Henoch-Schönlein nephritis between the first delivery and the second pregnancy. She developed Henoch-Schönlein purpura possibly due to rebound activation of immune response in the postpartum period after the disappearance of dramatic suppression of both humoral and cell-mediated immunity in the pregnant period.
Miyata
M
M
Department of Internal Medicine II, Fukushima Medical College, Japan.
Kumakawa
H
H
Funabashi
Y
Y
Suenaga
K
K
Hanzawa
S
S
Takahashi
M
M
Ogata
M
M
Kasukawa
R
R
D000328:Adult; D002908:Chronic Disease; D005260:Female; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications*; D011247:Pregnancy; D011248:Pregnancy Complications; D013966:Thyroiditis / Q000150:complications*