A case report of Henoch–Schönlein purpura in the elderly complicated by multisystem involvement
Song Na, Lei Zhang, Luxin Kou, Jinquan Xu, Li GangRationale:
Henoch–Schönlein purpura (HSP), a vasculitis caused predominantly by immunoglobulin A vasculitis deposition in the blood vessel wall. It frequently affects multiple organs, however, intussusception and cardiac involvement in the elderly is extremely rare. Currently, the diagnosis of patients with atypical HSP is very difficult. Drugs and treatments lack adequate evidence-based medical proof to improve patients’ long-term outcomes. We report a case of an elderly patient with allergic purpura involving the intestines, kidneys and heart, and discuss the diagnosis and treatment of patients with atypical clinical symptoms.
Patient concerns:
A 72-year-old woman whose initial symptoms were unusual, and the progression of the disease is irregular.
Diagnoses:
The patient with HSP gradually developed intussusception, renal failure and cardiac involvement.
Interventions and outcomes:
The patient developed kidney injury and intussusception, we sequentially administered surgical intervention, glucocorticoids, hemofiltration and hemoperfusion, and her condition showed improvement. Unfortunately, by the time cardiac complications develop, the patient’s condition deteriorated rapidly. At last, the patient died.
Lessons:
HSP with renal failure, intussusception, and cardiac complication is extremely rare. When patients with atypical HSP, we should always be alerted to changes in their condition. And take into account factors such as the severity of symptoms, patient preferences and complications in order to determine the most suitable therapies.