A case of refractory Henoch-Schönlein purpura treated with thalidomide.
Henoch-Schönlein purpura is an acute, self-limited vasculitis syndrome which shows characteristic skin, joint, renal and gastrointestinal manifestations. It is common in childhood and may also occur in adults with fatal complications such as nephritis and gastrointestinal bleeding. We experienced a case of a 20-year-old woman who presented with palpable purpura and severe arthritis. The histopathologic examination of the skin revealed leukocytoclastic vasculitis with perivascular deposition of IgA and she was diagnosed with Henoch-Schönlein purpura. Despite treatment with prednisolone for one month, she had more aggravated purpura and fatal gastrointestinal bleeding. The symptoms were improved shortly by cyclophosphamide pulse therapy with plasmapheresis but symptoms were aggravated and symmetric mononeuropathy of the ulnar nerve developed. She was treated with 400 mg/day of thalidomide and symptoms were improved. We herein report a case of Henoch-Schönlein purpura successfully treated with thalidomide which was refractory to prednisolone, immunosuppressive drugs and plasmapheresis.
Choi
Soo Jeong
SJ
Department of Internal Medicine, Soonchunhyang University Medical College, Seoul, Korea.
Park
Sung Kyu
SK
Uhm
Wan Sik
WS
Hong
Dae Sik
DS
Park
Hee Sook
HS
Park
Young Lip
YL
Kwon
Kye Won
KW
D000328:Adult; D003879:Dermatologic Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D011695:IgA Vasculitis / Q000188:drug therapy*; D013792:Thalidomide / Q000627:therapeutic use*
D003879:Dermatologic Agents; D013792:Thalidomide