Adult onset anaphylactoid purpura with severe gastrointestinal involvement.
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.
Oshima
Kazumi
K
Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, Niigata.
Iino
Noriaki
N
Sasaki
Natsue
N
Takahashi
Naoki
N
Tanabe
Yoshinari
Y
Ito
Satoshi
S
Ueno
Mitsuhiro
M
Nishi
Shin-ichi
S
Tsukada
Hiroki
H
Narita
Ichiei
I
Hasegawa
Go
G
Suzuki
Eiichi
E
Gejyo
Fumitake
F
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*
D000935:Antifungal Agents; D018501:Antirheumatic Agents; D005936:Glucans; D003520:Cyclophosphamide; D015725:Fluconazole; D011239:Prednisolone