Journal of Yeungnam Medical Science

영남대 의대 학술지 편집위원회 (Yeungnam University College of Medicine, Yeungnam University Institute Medical Science)
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급성 신부전을 동반한 성인 Henoch-Sch$\ddot{o}$nlein 자반증 1예

A Case of Adult onset Henoch-Sch$\ddot{o}$nlein Purpura with Acute Renal Failure

  • 김석민 (영남대학교 의과대학 내과학교실) ;
  • 장경애 (영남대학교 의과대학 내과학교실) ;
  • 정선영 (영남대학교 의과대학 내과학교실) ;
  • 박찬서 (영남대학교 의과대학 내과학교실) ;
  • 박종원 (영남대학교 의과대학 내과학교실) ;
  • 도준영 (영남대학교 의과대학 내과학교실) ;
  • 김용진 (영남대학교 의과대학 병리학교실) ;
  • 윤경우 (영남대학교 의과대학 내과학교실)
  • Kim, Seok-Min (Department of Internal Medicine, College of Medicine, Yeungnam University) ;
  • Chang, Kyung-Ae (Department of Internal Medicine, College of Medicine, Yeungnam University) ;
  • Jung, Sun-Young (Department of Internal Medicine, College of Medicine, Yeungnam University) ;
  • Park, Chan-Soh (Department of Internal Medicine, College of Medicine, Yeungnam University) ;
  • Park, Jong-Won (Department of Internal Medicine, College of Medicine, Yeungnam University) ;
  • Do, Jun-Young (Department of Internal Medicine, College of Medicine, Yeungnam University) ;
  • Kim, Yong-Jin (Department of Pathology, College of Medicine, Yeungnam University) ;
  • Yoon, Kyung-Woo (Department of Internal Medicine, College of Medicine, Yeungnam University)
  • 발행 : 2008.06.30
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초록

Henoch-Sch$\ddot{o}$nlein purpura (HSP) is a leukocytoclastic vasculitis of small vessels with deposition of IgA, commonly resulting in skin, joint, gastrointestinal, and kidney involvement. HSP is an uncommon disorder in adults and accounts for 0.6% to 2% of adult nephropathy. We report a case of HSP with acute renal failure successfully treated with corticosteroid. In this case, the patient presented with vasculitic purpuric rash on lower extremity, arthralgia in the wrist, abdominal pain, hematochezia, oliguria and azotemia. Abdominal CT showed wall thickening of the small and large bowels. Skin biopsy revealed leukocytoclastic vasculitis. Percutaneous renal biopsy showed no crescent formation, but mesangial IgA and $C_3$ deposits were observed by immunofluorescence. The patient was treated with corticosteroid (1mg/kg per day) and hemodialysis. After treatment, renal function improved and purpuric lesion, arthralgia and abdominal pain disappeared. Thus, when adults present with purpuric rash and rapidly progressive glomerulonephritis (RPGN), HSP should be a diagnostic consideration.

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