Diagnosis and management of Henoch-Schonlein purpura in Indonesian elderly with severe complication: A rare case

BACKGROUND: Henoch-Schonlein purpura (HSP) in the elderly is very rare, so this case report was conducted to improve the diagnosis and management of HSP. CASE PRESENTATION: A 65-year-old Indonesian male with severe complications of HSP had been reported. In addition to the patient's history, physical examination, laboratory and radiological findings, he performed a left sole anterior biopsy that showed interstitial infiltrate of main neutrophils, and faint granular deposits of IgA and C3 seen within the superficial vessels. He also had severe complications of gastrointestinal bleeding, extensive leukocytoclastic skin vasculitis, renal, and neurological manifestations. He had been given a pulse steroid, cyclophosphamide. He also planned to receive rituximab but canceled due to his worsening condition. DISCUSSION: Poor prognosis in the management of HSP in the elderly needs more attention to minimize mortality. CONCLUSION: Management of HSP in the elderly patient is challenging as it is a rare case, with a tendency for severe manifestations and rapid progression.