Henoch-Schönlein purpura fulminant

Authors

  • Daniel Artiles Martínez Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara
  • Arletis Ferrer Pérez Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara
  • Johamel Ramos Valdés Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara
  • Lisbetty López Gonzalez Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara
  • Pedro Alberto Marrero García Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara
  • Merlyn Arce Nuñez Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara
  • Osbel Quintana Morales Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara
  • Miguel Fernández Olivares Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara
  • Lázaro Vázquez Gómez Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara
  • Juan Humberto Gutiérrez Ronquillo Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara

Keywords:

purpura, Schoenlein-Henoch, purpura fulminans

Abstract

A female patient of 51 years old with personal pathological precedent of bronchial asthma, hypertension and ulcerative colitis and infection by chikungunya virus for a month. She incomes with dark pasty diarrhea with mucus and blood, she evolved unfavorably with flaccid paraplegia and recticularis livedo, which became extensive purple; then phlyctena and generalized edema. She remained hypotensive with electrolyte imbalance and impairment of consciousness, complementaries were performed, she was transfused and underwent to hemodialysis; she evolved to coma and death. The pathological findings showed an adult, fulminant and deadly form of anaphylactoid purpura or Henoch-Schönlein. Mesangial proliferation with fushinofílicos mesangial deposits werefound corresponding to immunoglobulin A with immunofluorescence, leukocytoclastic vasculitis and necrotizing vasculitis of small vessels. Purple of Schönlein-Henoch is a peculiar form of vasculitis that tends to spontaneous healing and occasionally may have a fatal course or proceed to a chronic nephritis.

Downloads

Download data is not yet available.

Author Biographies

Daniel Artiles Martínez, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara

Especialista de I Grado en Anatomía Patológica.
Profesor Asistente de la Universidad de Ciencias Médicas “Dr. Serafín Ruiz de Zárate Ruiz” de Villa Clara.

Arletis Ferrer Pérez, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara

Especialista de I Grado en Anatomía Patológica.
Profesora Asistente de la Universidad de Ciencias Médicas “Dr. Serafín Ruiz de Zárate Ruiz” de Villa Clara.

Johamel Ramos Valdés, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara

Especialista de II Grado en Anatomía Patológica.
Profesor Asistente de la Universidad de Ciencias Médicas “Dr. Serafín Ruiz de Zárate Ruiz” de Villa Clara.

Lisbetty López Gonzalez, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara

Residente de Anatomía Patológica

Pedro Alberto Marrero García, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara

Especialista de I Grado en Ortopedia y Traumatología, Profesor Asistente de la Universidad de Ciencias Médicas “Dr. Serafín Ruiz de Zárate Ruiz” de Villa Clara.

Merlyn Arce Nuñez, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara

Especialista de II Grado en Gastroenterología.
Profesora Asistente de la Universidad de Ciencias Médicas “Dr. Serafín Ruiz de Zárate Ruiz” de Villa Clara.

Osbel Quintana Morales, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara

Especialista de I Grado en Medicina Interna

Miguel Fernández Olivares, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara

Especialista de I Grado en Nefrología

Lázaro Vázquez Gómez, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara

Residente de 2do año en Neurología

Juan Humberto Gutiérrez Ronquillo, Hospital Clínico Quirúrgico “Arnaldo Milián Castro”, Santa Clara, Villa Clara

Especialista de II Grado en Neurología.
Profesor Auxiliar de la Universidad de Ciencias Médicas “Dr. Serafín Ruiz de Zárate Ruiz” de Villa Clara.

References

1. Ordoñez NG, Rosai J. Urinary tract: kidney, renal pelvis and ureter; bladder. En: Rosai J. Rosai and Ackerman's Surgical Pathology. 10th ed. New York: Elsevier; 2011. p. 1102-1206.

2. Kumar V, Abbas AK, Aster JC. Blood vessels. En: Robbins basic pathology. 9th ed. Philadelphia: Elsevier; 2013. p. 327-363.

3. Chen P, Zhu XB, Ren P, Wang YB, Sun RP, Wei DE. Henoch Schonlein Purpura in children: clinical analysis of 120 cases. AJOL [Internet]. 2013 [citado 15 Feb 2014];13(1):[aprox. 3 p.]. Disponible en: http://www.ajol.info/index.php/ahs/article/view/87280

4. WebMD, LLC. Henoch-Schonlein Purpura (HSP) [Internet]. ©2005-2015 [citado 15 Feb 2014]. Disponible en: http://www.webmd.com/skin-problems-and-treatments/henoch-schonlein-purpura-causes-symptoms-treatment

5. Mao S, Xuan X, Sha Y, Zhao S, Zhu C, Zhang A, et al. Clinico-pathological association of Henoch-Schoenlein purpura nephritis and IgA nephropathy in children. Int J Clin Exp Pathol [Internet]. 2015 Mar 1 [citado 15 Abr 2015];8(3):2334-42. Disponible en: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4440049/

6. Sotoodian B, Robert J, Mahmood MN, Yacyshyn E. IgA cutaneous purpura post-renal transplantation in a patient with long-standing IgA nephropathy: case report and literature review. J Cutan Med Surg [Internet]. 2015 Sep-Oct [citado 19 Nov 2015];19(5):498-503. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/25876643

7. Schonlein-Henoch Púrpura (SHP) [Internet]. ©1995-2015 [citado 15 Feb 2015]. Disponible en: http://kidshealth.org/parent/en_espanol/medicos/hsp_esp.html

8. Scheinfeld NS, Langman CB. Henoch-Schonlein Purpura [Internet]. ©1995-2015 [actualizado 28 Sept 2015; citado 15 Nov 2015]. Disponible en: http://emedicine.medscape.com/article/984105-overview#a1

9. Paydary K, Emamzadeh Fard S, Mahboubi AH, Ziaee V, Moradinejad MH, et al. Penile skin involvement as the first presentation of Henoch-Schonlein Purpura. Report of nine cases and review of literature. Iran J Pediatr [Internet]. 2015 Agos [citado 15 Oct 2015];25(4):e2177. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/26396696

10. Sheth K, Bockorny M, Elaba Z, Scola C. Adult onset Henoch-Schönlein Purpura: case report and review of literature. Conn Med [Internet]. 2015 Feb [citado 15 Abr 2015];79(2):81-5. Disponible en: http://www.ncbi.nlm.nih.gov/pubmed/26244205

How to Cite

1.
Artiles Martínez D, Ferrer Pérez A, Ramos Valdés J, López Gonzalez L, Marrero García PA, Arce Nuñez M, et al. Henoch-Schönlein purpura fulminant. Acta Méd Centro [Internet]. 2015 Dec. 23 [cited 2025 Jun. 28];9(4):102-11. Available from: https://revactamedicacentro.sld.cu/index.php/amc/article/view/309

Issue

Section

Clinicopathological Sessions