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Severe iga vasculitis with features of remitting seronegative symmetrical synovitis with pitting edema (RS3PE) syndrome in a 60‐year‐old male treated with plasmapheresis

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Rheumatology & Autoimmunity 2022年第2期2卷 98-101页

作者： Shawn Mathew Rohan Goyal Nealansh Gupta Rauno Joks Internal Medicine Ringgold Standard InstitutionSUNY Downstate Health Sciences UniversityBrooklynNew YorkUSA SUNY Downstate Medical Center College of Medicine Ringgold Standard InstitutionBrooklynNew YorkUSA Allergy and Immunology Center for Allergy and Asthma ResearchSUNY Downstate Health Sciences UniversityBrooklynNew YorkUSA

Objective:To explore a possible association between systemic immunoglobulin A(iga)vasculitis and RS3PE syndrome and to investigate specific treatment regimens for adults who present with iga vasculitis with renal ***:The patient was treated with plasmapheresis and fresh frozen plasma(FFP)every other day with 1g methylprednisolone daily for three days followed by oral prednisone *** mofetil twice daily and trimethoprim‐sulfamethoxazole for Pneumocystis jirovecii prophylaxis was *** total the patient received two cycles of plasmapheresis and fresh frozen ***:The patient's renal function drastically improved with resolution of both abdominal pain and ***:We illustrate a possible association between systemic iga vasculitis and RS3PE syndrome,and this case demonstrates iga vasculitis with renal involvement that acutely resolved with high‐dose glucocorticoids and ***,our specific treatment regimen can be a potential standard of care for adults who present with iga vasculitis with renal involvement.

关键词： iga vasculitis plasmapheresis RS3PE syndrome

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An Atypical Cause of Abdominal Pain in an Elderly Patient

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Open Journal of Nephrology 2021年第3期11卷 370-378页

作者： Yaroslav Andrew Jakymec Cara Sherman Michelle Annabi-Rabadi Majed Samarneh Hanady Zainah Lake Erie College of Osteopathic Medicine Erie Pennsylvania USA Department of Medicine St. John’s Riverside Hospital Yonkers New York USA

Background: Henoch-Schonlein Purpura (HSP), or iga vasculitis, is the most common vasculitis in children and is characterized by four symptoms: palpable purpura with no concurrent thrombocytopenia or coagulopathy, arthritis/ arthralgias, abdominal pain, and renal disease. HSP does occur in older patients at a much lower frequency. Objective: To discuss the atypical presentation of HSP in an elderly adult and the increased nephrogenic risks that are involved in this patient group. Case Presentation: We present the history, physical findings, laboratory results, and the clinical course of a 74-year-old Caucasian male with an atypical presentation of HSP. Our patient presented with severe gastrointestinal and cutaneous symptoms which occurred after the onset of abdominal pain. Biopsies demonstrated leukocytoclastic vasculitis in the skin and acute inflammation and hemorrhage in the gastrointestinal tract. The diagnosis was confirmed as iga vasculitis following the renal biopsy. The patient’s symptoms improved with the administration of methylprednisolone. Conclusion: In adults with HSP there is greater concern regarding renal involvement and a greater risk of developing end-stage renal disease compared to children. The importance of recognizing HSP in the elderly is imperative for early diagnosis and appropriate treatment to limit renal damage.

关键词： Henoch-Schonlein Purpura iga vasculitis Leukocytoclastic vasculitis

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