Joshi Stuti, Pillai Sooraj, Chakera Aron, Lee Y C Gary
Department of Respiratory Medicine, Sir Charles Gairdner Hospital Perth, Western Australia, Australia.
PathWest Laboratory Medicine, QE II Med Ctr Perth, Western Australia, Australia.
Respirol Case Rep. 2014 Dec;2(4):138-40. doi: 10.1002/rcr2.78. Epub 2014 Sep 23.
Henoch-Schonlein purpura (HSP) is primarily a childhood immunoglobulin A (IgA)-mediated illness. When adults are affected, malignancy can be associated. We present a rare case of HSP in a 75-year-old man with malignant pleural mesothelioma. He presented with episodes of dizziness and subsequently developed non-palpable purpura across his legs, arthralgia, hematuria, proteinuria, and acute renal impairment. HSP was diagnosed based on clinical and histological findings on biopsy specimens from the skin and kidney that showed a leukocytoclastic vasculitis and mesangioproliferative glomerulonephritis with IgA deposits, respectively. He was treated with high-dose oral steroids with resolution of the skin and renal manifestations of the disease. HSP is rare in adults but has been linked to cancers. This is the first report of HSP in a patient with known malignant pleural mesothelioma.
过敏性紫癜（HSP）主要是一种儿童期免疫球蛋白A（IgA）介导的疾病。当成年人患病时，可能与恶性肿瘤有关。我们报告了一例75岁患有恶性胸膜间皮瘤的男性罕见的过敏性紫癜病例。他起初出现头晕发作，随后双下肢出现不可触及的紫癜、关节痛、血尿、蛋白尿和急性肾功能损害。根据皮肤和肾脏活检标本的临床及组织学检查结果诊断为过敏性紫癜，分别显示白细胞破碎性血管炎和伴有IgA沉积的系膜增生性肾小球肾炎。他接受了大剂量口服类固醇治疗，疾病的皮肤和肾脏表现得以缓解。过敏性紫癜在成年人中很少见，但与癌症有关。这是已知患有恶性胸膜间皮瘤患者发生过敏性紫癜的首例报告。
