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  Vol. 137 No. 1, January 2001 TABLE OF CONTENTS
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  Critical Situations: Dermatology in the Acute Care Setting
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Adult Henoch-Schönlein Purpura With Fatal Complications

Rebecca McCarthy, MD; Ted Rosen, MD; San-Hwan Chen, MD; Sharon S. Raimer, MD

Arch Dermatol. 2001;137:19-21.

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

REPORT OF 2 CASES

CASE 1

A 63-year-old man with a history of diabetes, hypertension, depression, and stroke presented with a 1-week history of diarrhea, nausea, arthralgia, and acral purpuric eruption as well as progressively increasing abdominal pain. On examination he was noted to have palpable purpura on his hands and feet (Figure 1), bloody stool, and abdominal distention. Petechial hemorrhages throughout the small bowel were discovered on exploratory laparotomy. Laboratory findings revealed hematuria, elevated serum urea nitrogen and creatinine levels, and an increased sedimentation rate. Skin biopsy results showed a leukocytoclastic vasculitis and granular deposition of IgA (Figure 2), IgM, and C3 in capillaries consistent with Henoch-Schönlein purpura (HSP). Test results for antinuclear antibodies, antineutrophil cytoplasmic antibodies, viral hepatitis, cryoglobulins, and cryofibrinogens were all negative.


 
Figure appears in full text version.
Figure 1. Palpable purpura on the foot of patient 1.



 
Figure appears in full text version.
Figure 2. Granular . . . [Full Text of this Article]


CASE 2

DIAGNOSTIC CHALLENGE

COMMENT

From the University of Texas Medical Branch, Galveston (Drs McCarthy, Chen, and Raimer); Baylor College of Medicine, Houston, Tex (Dr Rosen).



THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

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NEJM 2003;349:597-601.
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