Tuyển tập báo cáo các nghiên cứu khoa học quốc tế ngành y học dành cho các bạn tham khảo đề tài: Henoch-Schönlein purpura in an older man presenting as rectal bleeding and IgA mesangioproliferative glomerulonephritis: a case report. | Cheungpasitporn et al. Journal of Medical Case Reports 2011 5 364 http content 5 1 364 JOURNALOF medical Ur Case REPORTS CASE REPORT Open Access Henoch-Schonlein purpura in an older man presenting as rectal bleeding and IgA mesangioproliferative glomerulonephritis a case report Wisit Cheungpasitporn Teeranun Jirajariyavej Charles B Howarth and Raquel M Rosen Abstract Introduction Henoch-Schonlein purpura is the most common systemic vasculitis in children. Typical presentations are palpable purpura abdominal pain arthritis and hematuria. This vasculitic syndrome can present as an uncommon cause of rectal bleeding in older patients. We report a case of an older man with Henoch-Schonlein purpura. He presented with rectal bleeding and acute kidney injury secondary to IgA mesangioproliferative glomerulonephritis. Case presentation A 75-year-old Polish man with a history of diverticulosis presented with a five-day history of rectal bleeding. He had first noticed colicky left lower abdominal pain two months previously. At that time he was treated with a 10-day course of ciprofloxacin and metronidazole for possible diverticulitis. He subsequently presented with rectal bleeding to our emergency department. Physical examination revealed generalized palpable purpuric rash and tenderness on his left lower abdomen. Laboratory testing showed a mildly elevated serum creatinine of . Computed tomography of his abdomen revealed a diffusely edematous and thickened sigmoid colon. Flexible sigmoidoscopy showed severe petechiae throughout the colon. Colonic biopsy showed small vessel acute inflammation. Skin biopsy resulted in a diagnosis of leukocytoclastic vasculitis. Due to worsening kidney function microscopic hematuria and new onset proteinuria he underwent a kidney biopsy which demonstrated IgA mesangioproliferative glomerulonephritis. A diagnosis of Henoch-Schonlein purpura was made. Intravenous methylprednisolone was initially started and .
