title: Fatal Henoch-Schönlein purpura in an adult with Dieulafoy lesions.
abstract: Henoch-Schönlein purpura (HSP) is considered a benign disease of children. We report a severe case of HSP in an adult causing renal failure and gastrointestinal (GI) hemorrhage. Despite aggressive treatment with corticosteroids, cyclophosphamide, and plasmapheresis, the patient developed massive GI bleeding from 2 Dieulafoy lesions and died weeks after bowel resection. Although uncommon, when massive GI hemorrhage occurs, actively bleeding Dieulafoy lesions, although uncommon, should be suspected and evaluated early.
authors: Rheumatology Division, Roger Williams Medical Center, Boston University, Boston, MA, USA. ocluzie@gmail.com
authors: Dan A
authors: DA
authors: Cristescu
authors: Candice
authors: C
authors: Yuvienco
authors: Stuart
authors: S
authors: Schwartz
mesh_terms: D000368:Aged; D017546:Angioscopy; D018501:Antirheumatic Agents / Q000008:administration & dosage; D001706:Biopsy; D003113:Colonoscopy; D003131:Combined Modality Therapy; D003520:Cyclophosphamide / Q000008:administration & dosage; D017809:Fatal Outcome; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D005938:Glucocorticoids / Q000008:administration & dosage; D006801:Humans; D011695:IgA Vasculitis / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D007082:Ileum / Q000098:blood supply*; D007413:Intestinal Mucosa / Q000098:blood supply; D007583:Jejunum / Q000098:blood supply*; D008297:Male; D017538:Mesenteric Artery, Superior / Q000002:abnormalities*; D010956:Plasmapheresis; D014057:Tomography, X-Ray Computed
chemical_list: D018501:Antirheumatic Agents; D005938:Glucocorticoids; D003520:Cyclophosphamide