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High-dose methylprednisolone pulse therapy for treatment of refractory intestinal involvement caused by Henoch–Schönlein purpura: a case report

INTRODUCTION: Henoch–Schönlein purpura is an immunoglobulin A-mediated, small vascular inflammatory disease that can be associated with palpable purpura, arthralgia, abdominal pain, or nephritis. The presence of purpura facilitates the diagnosis of Henoch–Schönlein purpura at the onset of associated...

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Autores principales: Kang, Hyun Sik, Chung, Hee Sup, Kang, Ki-Soo, Han, Kyoung Hee
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378549/
https://www.ncbi.nlm.nih.gov/pubmed/25885905
http://dx.doi.org/10.1186/s13256-015-0545-4
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author Kang, Hyun Sik
Chung, Hee Sup
Kang, Ki-Soo
Han, Kyoung Hee
author_facet Kang, Hyun Sik
Chung, Hee Sup
Kang, Ki-Soo
Han, Kyoung Hee
author_sort Kang, Hyun Sik
collection PubMed
description INTRODUCTION: Henoch–Schönlein purpura is an immunoglobulin A-mediated, small vascular inflammatory disease that can be associated with palpable purpura, arthralgia, abdominal pain, or nephritis. The presence of purpura facilitates the diagnosis of Henoch–Schönlein purpura at the onset of associated symptoms, whereas the absence of purpura makes the diagnosis challenging. It is important to diagnose Henoch–Schönlein purpura with delayed-onset skin purpura to avoid unnecessary surgery for acute abdomen. Most cases of Henoch–Schönlein purpura with severe abdominal pain are treated with low-dose steroids and intravenous immunoglobulin. CASE PRESENTATION: A 15-year-old Korean girl complained of severe abdominal pain and delayed-onset purpura on admission. Henoch–Schönlein purpura was diagnosed based on endoscopic findings of hemorrhagic duodenitis and duodenal vasculitis and abdominal computed tomography findings of edematous bowels. Two common initial treatments, a low-dose steroid and intravenous immunoglobulin, were administered, but there was no improvement for 1 month. Subsequently, we used high-dose intravenous methylprednisolone pulse therapy (30mg/kg/day, with a maximum of 1g/day), which dramatically alleviated her abdominal symptoms. CONCLUSIONS: High-dose intravenous methylprednisolone pulse therapy can be used as the ultimate treatment for delayed-onset Henoch–Schönlein purpura with severe abdominal pain when symptoms do not improve after low-dose steroid and intravenous immunoglobulin treatments.
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spelling pubmed-43785492015-03-31 High-dose methylprednisolone pulse therapy for treatment of refractory intestinal involvement caused by Henoch–Schönlein purpura: a case report Kang, Hyun Sik Chung, Hee Sup Kang, Ki-Soo Han, Kyoung Hee J Med Case Rep Case Report INTRODUCTION: Henoch–Schönlein purpura is an immunoglobulin A-mediated, small vascular inflammatory disease that can be associated with palpable purpura, arthralgia, abdominal pain, or nephritis. The presence of purpura facilitates the diagnosis of Henoch–Schönlein purpura at the onset of associated symptoms, whereas the absence of purpura makes the diagnosis challenging. It is important to diagnose Henoch–Schönlein purpura with delayed-onset skin purpura to avoid unnecessary surgery for acute abdomen. Most cases of Henoch–Schönlein purpura with severe abdominal pain are treated with low-dose steroids and intravenous immunoglobulin. CASE PRESENTATION: A 15-year-old Korean girl complained of severe abdominal pain and delayed-onset purpura on admission. Henoch–Schönlein purpura was diagnosed based on endoscopic findings of hemorrhagic duodenitis and duodenal vasculitis and abdominal computed tomography findings of edematous bowels. Two common initial treatments, a low-dose steroid and intravenous immunoglobulin, were administered, but there was no improvement for 1 month. Subsequently, we used high-dose intravenous methylprednisolone pulse therapy (30mg/kg/day, with a maximum of 1g/day), which dramatically alleviated her abdominal symptoms. CONCLUSIONS: High-dose intravenous methylprednisolone pulse therapy can be used as the ultimate treatment for delayed-onset Henoch–Schönlein purpura with severe abdominal pain when symptoms do not improve after low-dose steroid and intravenous immunoglobulin treatments. BioMed Central 2015-03-24 /pmc/articles/PMC4378549/ /pubmed/25885905 http://dx.doi.org/10.1186/s13256-015-0545-4 Text en © Kang et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Case Report
Kang, Hyun Sik
Chung, Hee Sup
Kang, Ki-Soo
Han, Kyoung Hee
High-dose methylprednisolone pulse therapy for treatment of refractory intestinal involvement caused by Henoch–Schönlein purpura: a case report
title High-dose methylprednisolone pulse therapy for treatment of refractory intestinal involvement caused by Henoch–Schönlein purpura: a case report
title_full High-dose methylprednisolone pulse therapy for treatment of refractory intestinal involvement caused by Henoch–Schönlein purpura: a case report
title_fullStr High-dose methylprednisolone pulse therapy for treatment of refractory intestinal involvement caused by Henoch–Schönlein purpura: a case report
title_full_unstemmed High-dose methylprednisolone pulse therapy for treatment of refractory intestinal involvement caused by Henoch–Schönlein purpura: a case report
title_short High-dose methylprednisolone pulse therapy for treatment of refractory intestinal involvement caused by Henoch–Schönlein purpura: a case report
title_sort high-dose methylprednisolone pulse therapy for treatment of refractory intestinal involvement caused by henoch–schönlein purpura: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4378549/
https://www.ncbi.nlm.nih.gov/pubmed/25885905
http://dx.doi.org/10.1186/s13256-015-0545-4
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