Henoch-Schönlein Purpura in an Obese Adult with Elevated Transaminase: A Case Report and Literature Review

BACKGROUND: Henoch-Schönlein Purpura (HSP) cases are uncommon among adults due to their self-limiting nature and difficulty in diagnosis. The involvement of the hepatobiliary system and the effect of obesity is still not well understood among adults. CASE DESCRIPTION: A 28-year-old obese male presented with an acute onset of generalized palpable purpura, fever, abdominal discomfort, and arthralgias. Laboratory examination indicated leukocytosis (43,100/µL), thrombocytosis (550,000/µL), and elevated transaminase levels (AST 125 U/L, ALT 131 U/L). Skin biopsy revealed perivascular inflammatory infiltrates in the superficial dermal vessels. Treatment of corticosteroids and antibiotics resulted in progressive clinical improvement. CONCLUSION: Although rare in adults, recognizing multiple presentations of HSP allows early diagnosis. This case highlights elevated transaminase levels and obesity contributed to increased inflammatory responses that may complicate HSP diagnosis. Despite severity, a complete recovery is possible if diagnosed early and managed appropriately.