High-dose methylprednisolone pulse therapy for treatment of refractory intestinal involvement caused by Henoch-Schönlein purpura: a case report
| Autor: | Ki-Soo Kang, Hee Sup Chung, Hyun Sik Kang, Kyoung Hee Han |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Vasculitis
Abdominal pain medicine.medical_specialty Henoch-Schonlein purpura Adolescent IgA Vasculitis Anti-Inflammatory Agents Case Report Gastroenterology Methylprednisolone Duodenitis Gastrointestinal tract immune system diseases Internal medicine hemic and lymphatic diseases Pulse therapy medicine Humans Immunologic Factors Palpable purpura Medicine(all) business.industry Immunoglobulins Intravenous General Medicine medicine.disease Surgery Abdominal Pain Purpura Acute abdomen Female medicine.symptom business Henoch–Schönlein purpura medicine.drug |
| Zdroj: | Journal of Medical Case Reports |
| ISSN: | 1752-1947 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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