Henoch-Schönlein purpura with intracerebral haemorrhage in an adult patient: a case report
Henoch-Schönlein purpura with intracerebral haemorrhage in an adult patient: a case report
Abstract
Introduction:
Henoch-Schönlein purpura is a small vessel vasculitis that affects mainly the skin, joints, gastrointestinal tract and kidneys. The central nervous system is also occasionally affected, although the majority of patients experience only mild symptoms such as headaches and behavioural changes. Intracerebral haemorrhage is a rare complication of Henoch-Schönlein purpura that so far has mainly been described in children and young adolescence.
Case presentation:
We describe a 42-year-old man with Henoch-Schönlein purpura who developed an acute intracerebral haemorrhage that coincided with a reactivation of his vasculitis and the development of renal failure following discontinuation of steroids. In this patient, both the Henoch-Schönlein purpura and his neurological symptoms were successfully treated with intravenous cyclophosphamide and methylprednisolone, followed by a short course of oral cyclophosphamide and long-term oral prednisolone. His renal function also recovered sufficiently not to require renal replacement therapy.
Conclusion:
The management of Henoch-Schönlein nephritis remains unclear, especially in the presence of severe complications such as intracerebral haemorrhage. We describe a successful outcome in such a patient.
Introduction
Henoch-Schönlein purpura (HSP) is a small vessel vasculitis characterized by IgA1 deposition in the renal mesangium and in the blood vessels. It is seen most frequently in early childhood, although it can occur at any age [1,2]. It is usually preceded by upper respiratory tract infections, having a peak incidence in the autumn and winter [1,2]. In most cases it is a self-limiting disorder and tends to resolve within 1 month of presentation, although it can re-occur in a third of cases [1,2].
HSP affects mainly the skin, joints, gastrointestinal tract and kidneys [1-3]. The severity of symptoms is usually worse in older patients, who tend to have more frequent skin, joint and renal involvement [2]. The central nervous system is also occasionally affected, although the majority of patients experience only mild symptoms such as headaches and behavioural changes [3]. More serious neurological complications are rare and include seizures, cranial or peripheral neuropathies, intracerebral haemorrhage and encephalopathy [1,3]. We describe a man with HSP who developed an acute intracerebral haemorrhage that coincided with a reactivation of his vasculitis.
intracerebral subarachnoid haemorrhage, intracerebral hemoorhage stroke, acute intracerebral hemorrhage, intracerebral brain haemorrhage, intracerebral hemorrhage surgery, Henoch-Schönlein purpura diagnosis, Henoch-Schönlein purpura syndrome, Henoch-Schönlein purpura vasculitis, Henoch-Schönlein purpura rash,
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