[Muscular haematoma in Henoch-Schönlein purpura].
BACKGROUND
Henoch-Schonlein purpura is one of the most frequent systemic vasculitis in children. In adults, muscle involvement is extremely rare and not very well characterized. We report a case of Henoch-Schonlein purpura with severe skin and renal involvement in witch multiple intramuscular haematoma leaded to severe anaemia. Histological examination confirms the muscle localization of the disease.


METHODS
A 68 years old man treated by oral anticoagulation for multiple venous thrombosis, was admitted with necrotic vasculitis of the skin, abdominal pain and segmental IgA glomerulopathy. The diagnosis of Henoch-Schonlein purpura was rapidly made and intensive steroid therapy started. After rapid improvement, a haemorrhagic shock due to voluminous intramuscular haematoma was diagnosed by MRI. Histological examination of the muscle, confirms the localization of the disease.


CONCLUSIONS
Intramuscular haematomas are very uncommon in Henoch-Schonlein purpura. There are usually a consequence of muscular immune complex vasculitis. In our patient, high dose corticosteroid was not unable to control the disease.
Mahevas
M
M
Service de néphrologie, médecine interne, hôpital Sud, CHU d'Amiens, avenue René-Laennec-Salouel, 80054 Amiens cedex 01, France.
Makdassi
R
R
Presne
C
C
Bernasconi
T
T
Cordonnier
C
C
Fournier
A
A
Choukroun
G
G
D000368:Aged; D006406:Hematoma / Q000209:etiology*; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications*; D008297:Male; D009135:Muscular Diseases / Q000209:etiology*; D012720:Severity of Illness Index