An adult patient with Henoch-Schönlein purpura and non-occlusive mesenteric ischemia.
BACKGROUND
Onset of Henoch-Schönlein purpura (HSP) in middle age is uncommon, and adults with renal or gastrointestinal involvement present with more severe disease than do similar pediatric patients.


METHODS
We present the case of a 69-year-old male with HSP who, after treatment with steroids, cyclophosphamide, and continuous intravenous prostaglandin E1 (PGE1), died as a result of severe gastrointestinal involvement with non-occlusive mesenteric ischemia (NOMI). Vascular narrowing associated with the NOMI improved after catheter injection of PGE1 and prednisolone, but the patient died of bleeding from an exposed small vessel. At autopsy there was no active vasculitis in the jejunal submucosa.


CONCLUSIONS
Treatment with PGE1 and prednisolone might improve small-vessel vasculitis associated with NOMI.
Department of Allergy and Respirology, National Hospital Organization Sagamihara National Hospital, 18-1 Sakuradai, Minami-ku, Sagamihara, Kanagawa 252-0392, Japan.
Chiyako
C
Oshikata
Naomi
N
Tsurikisawa
Masakazu
M
Takigawa
Tomoko
T
Omori
Satoshi
S
Sugano
Takahiro
T
Tsuburai
Hiroyuki
H
Mitomi
Tamiko
T
Takemura
Kazuo
K
Akiyama
D000368:Aged; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications* / Q000000981:diagnostic imaging; D007511:Ischemia / Q000150:complications* / Q000000981:diagnostic imaging; D008297:Male; D065666:Mesenteric Ischemia; D014057:Tomography, X-Ray Computed; D014652:Vascular Diseases / Q000150:complications* / Q000000981:diagnostic imaging