Department of Gynaecology and Obstetrics, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.
Department of Internal Medicine, Intensive Care Unit, Sestre milosrdnice University Hospital Center, Zagreb, Croatia.
Biochem Med (Zagreb). 2018 Feb 15;28(1):010801. doi: 10.11613/BM.2018.010801. Epub 2018 Jan 10.
Henoch-Schönlein purpura (HSP) is an IgA-mediated small vessels' vasculitis that affects the skin, intestines and kidneys. Pregnancy has been reported as an exacerbating factor. We present the case of a 24-year-old with HSP that occurred in the third trimester and lasted up to the end of the successful delivery. She had pruritic maculopapular exanthema on her legs. Biopsy of a cutaneous lesion was performed for histopathologic features and direct immunofluorescence (DIF) for the presence of perivascular IgA deposition. Histopathology of the cutaneous lesion confirmed leukocytoclastic vasculitis. A DIF examination of the skin lesion confirmed deposits of fibrinogen in the small blood vessel walls. Six weeks following delivery, the skin lesions almost completely disappeared. Control laboratory findings were normal. This case of HSP might have been primarily associated with a preceding respiratory infection but this should first be carefully investigated due to a possible severe immunological disease in the patient's background requiring special attention since nephrotic symptoms may occur.
过敏性紫癜（HSP）是一种 IgA 介导的小血管血管炎，影响皮肤、肠道和肾脏。已有妊娠加重病情的报道。我们报告了一例 24 岁的 HSP 患者，她在妊娠晚期发病，一直持续到成功分娩结束。她的腿部出现瘙痒性斑丘疹。为了明确组织病理学特征和血管周围 IgA 沉积的直接免疫荧光（DIF），对皮肤病变进行了活检。皮肤病变的组织病理学检查证实为白细胞碎裂性血管炎。皮肤病变的 DIF 检查证实小血管壁有纤维蛋白原沉积。分娩后 6 周，皮肤病变几乎完全消失。实验室检查结果正常。这种 HSP 可能与先前的呼吸道感染有关，但由于患者可能存在严重的免疫性疾病，需要特别注意，因为可能会出现肾病症状，因此首先应仔细调查。
