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Cutaneous Vasculitis with Renal Impairment in Octogenarian

DOI: 10.4236/jbm.2017.56004, PP. 37-45

Keywords: Purple Henoch-Sch?nlein, Vasculitis, Renal, Elderly, Case Report

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Abstract:

Henoch-Schönlein purpura is a vasculitis of small vessels, characterized by tissue deposition of IgA, affecting predominantly the skin, intestine, joints and kidneys. It mainly affects the pediatric age group, especially from 2 to 11 years old. Most often, it is preceded by episode of upper airway infection from days to weeks. The most common clinical manifestations are purpuric cutaneous lesions located in the lower limbs and buttocks, abdominal pain in colic, nausea, vomiting, diarrhea, in addition to arthralgia/arthritis, usually with spontaneous resolution. Renal impairment usually manifests with hematuria and proteinuria, and renal function may also be impaired. The case described refers to a female patient, 86 years old, with a previous history of infection of the upper airways, followed by purpura in the lower limbs and renal impairment: serum creatinine 3.1 mg/dL (N 0.5 - 1.2 mg/dL); glomerular filtration rate 15 ml/min (N > 60 ml/min); urea 118 mg/dL (N < 40 g/dL); proteinuria 4.497 mg/24h. The present report aims to draw attention to the occurrence of Henoch-Schönlein purpura in an atypical age group, with significant renal impairment, improvement only with conservative treatment, thus avoiding the use of immunosuppressants and the risks of immunosuppression and toxicity related to such drugs.

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