title: Adult onset anaphylactoid purpura with severe gastrointestinal involvement.
abstract: We treated a case of adult-onset severe-form anaphylactoid purpura. This case had been diagnosed as anaphylactoid purpura pathologically by skin biopsy. However, his clinical manifestations were atypical in view of complicated massive gastrointestinal hemorrhage. Intensive therapy including corticosteroid and cyclophosphamide transiently improved his condition. Nevertheless, the beta-D-glucan value in peripheral blood was gradually elevated. Prophylactic use of fluconazole failed to prevent contraction of invasive mycosis. Finally, he suddenly suffered from diffuse cerebral hemorrhage. Postmortem examination revealed systemic invasive aspergillosis as the cause of death.
authors.affiliation: Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata.
authors.forename: Kazumi
authors.initials: K
authors.lastname: Oshima
authors.forename: Noriaki
authors.initials: N
authors.lastname: Iino
authors.forename: Natsue
authors.initials: N
authors.lastname: Sasaki
authors.forename: Naoki
authors.initials: N
authors.lastname: Takahashi
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Tanabe
authors.forename: Satoshi
authors.initials: S
authors.lastname: Ito
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Ueno
authors.forename: Shin-ichi
authors.initials: S
authors.lastname: Nishi
authors.forename: Hiroki
authors.initials: H
authors.lastname: Tsukada
authors.forename: Ichiei
authors.initials: I
authors.lastname: Narita
authors.forename: Go
authors.initials: G
authors.lastname: Hasegawa
authors.forename: Eiichi
authors.initials: E
authors.lastname: Suzuki
authors.forename: Fumitake
authors.initials: F
authors.lastname: Gejyo
mesh_terms: D017668:Age of Onset; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000009:adverse effects*; D001228:Aspergillosis / Q000097:blood / Q000139:chemically induced* / Q000401:mortality / Q000517:prevention & control*; D003520:Cyclophosphamide / Q000009:adverse effects*; D017809:Fatal Outcome; D015725:Fluconazole / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D005936:Glucans / Q000097:blood; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications / Q000188:drug therapy*; D008297:Male; D011239:Prednisolone / Q000009:adverse effects*
chemical_list: D000935:Antifungal Agents; D018501:Antirheumatic Agents; D005936:Glucans; D003520:Cyclophosphamide; D015725:Fluconazole; D011239:Prednisolone