Henoch-Schönlein Purpura in Adults: Clinical Features and Outcome

Bengü Nisa Akay
Ezgi Ünlü
Hatice Şanlı
Aynur Akyol

Abstract

Objective: Henoch-Schönlein purpura (HSP) is a leukocytoclastic vasculitis involving small vessels with the deposition of immune complexes containing IgA, and it primarily affects children. We aimed to analyze the etiologic factors, demographic features, clinical course, outcome, and response to treatment in adults with the diagnosis of HSP.

Materials and Methods: Between January 2003 and January 2008, 16 adult patients with HSP were evaluated retrospectively. We assessed duration of the disease, presence of associated symptoms, clinical findings, drug intake, response to treatment, recurrence rates, and extensive laboratory testing and radiologic evaluations in each patient to clarify a possible underlying etiology

Results: In a five-year period, 16 patients with HSP (7 female, 9 male, mean age: 53.38 ± 14.43) were evaluated. All patients had typical purpuric lesions located on the lower extremities followed by the upper extremities and trunk in 62.5% and 43.8%, respectively. Arthritis/arthralgia was present in 25% and gastrointestinal system involvement in 31.3% of the patients. History of a preceding upper respiratory tract infection and drug usage, mainly antibiotics and non-steroidal anti-inflammatory drugs, was found in 68.8% of the patients. Malignancy was detected in only one patient (6.3%). HSP was the first manifestation of systemic lupus erythematosus in one patient. Ten patients were treated only with systemic steroids, one patient with azathioprine plus systemic steroid, four patients with antihistamines plus topical steroids, and one with dapsone alone. All patients responded well to treatment and no recurrence was observed in any of our patients in a follow-up period of one to five years.

Conclusion: We found that previous drug treatment and previous upper respiratory tract infection were the main triggers in the development of adult HSP. Furthermore, HSP in adults is generally benign and self-limited. All patients responded well to treatment without recurrences.

Keywords

Purpura, Schoenlein-Henoch, vasculitis, adult
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