TY - JOUR
T1 - Cardiopulmonary manifestations of Henoch-Schonlein purpura
AU - Agraharkar, Mahendra
AU - Gokhale, Sumita
AU - Le, Linh
AU - Rajaraman, Srinivasan
AU - Campbell, Gerald A.
PY - 2000
Y1 - 2000
N2 - Henoch-Schonlein Purpura (HSP) is usually a mild condition involving the skin, gut, joints, and kidneys and has a good prognosis. We present a 63- year-old Hispanic man who had an unusually severe form of HSP with a fatal outcome attributable to vasculitis causing myocardial necrosis. There is only one citation in the literature of HSP-related myocardial vasculitis, which involved the right ventricle and was successfully treated with steroids. Our patient had severe HSP-related myocardial necrosis, tracheobronchitis, and nephritis. The bronchial lesions resolved, presumably because of steroid therapy. This probably is the first case of fatal myocardial necrosis related to HSP. We conclude that HSP can, in some cases, have an aggressive course. It becomes imperative to recognize the involvement of the other organ systems, such as the heart, so that appropriate therapy may be initiated. Immunosuppression may have a beneficial effect on extrarenal lesions. Controlled clinical trials are needed to establish the efficacy of such treatment. (C) 2000 National Kidney Foundation, Inc.
AB - Henoch-Schonlein Purpura (HSP) is usually a mild condition involving the skin, gut, joints, and kidneys and has a good prognosis. We present a 63- year-old Hispanic man who had an unusually severe form of HSP with a fatal outcome attributable to vasculitis causing myocardial necrosis. There is only one citation in the literature of HSP-related myocardial vasculitis, which involved the right ventricle and was successfully treated with steroids. Our patient had severe HSP-related myocardial necrosis, tracheobronchitis, and nephritis. The bronchial lesions resolved, presumably because of steroid therapy. This probably is the first case of fatal myocardial necrosis related to HSP. We conclude that HSP can, in some cases, have an aggressive course. It becomes imperative to recognize the involvement of the other organ systems, such as the heart, so that appropriate therapy may be initiated. Immunosuppression may have a beneficial effect on extrarenal lesions. Controlled clinical trials are needed to establish the efficacy of such treatment. (C) 2000 National Kidney Foundation, Inc.
KW - Cardiopulmonary vasculitis
KW - Henoch-Schonlein purpura (HSP)
KW - Immunoglobulin A (IgA) nephropathy
KW - Immunosuppressive therapy
KW - Myocardial necrosis
KW - Myocardial vasculitis
UR - http://www.scopus.com/inward/record.url?scp=0033969125&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0033969125&partnerID=8YFLogxK
U2 - 10.1016/S0272-6386(00)70344-1
DO - 10.1016/S0272-6386(00)70344-1
M3 - Article
C2 - 10676734
AN - SCOPUS:0033969125
SN - 0272-6386
VL - 35
SP - 319
EP - 322
JO - American Journal of Kidney Diseases
JF - American Journal of Kidney Diseases
IS - 2
ER -