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 abdominalpain. On examination he was noted to have palpable purpura on his hands andfeet (Figure 1), bloody stool, andabdominal distention. Petechial hemorrhages throughout the small bowel werediscovered on exploratory laparotomy. Laboratory findings revealed hematuria,elevated serum urea nitrogen and creatinine levels, and an increased sedimentationrate. Skin biopsy results showed a leukocytoclastic vasculitis and granulardeposition 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.
McCarthy R, Rosen T, Chen S, Raimer SS. Adult Henoch-Schönlein Purpura With Fatal Complications. Arch Dermatol. 2001;137(1):19-21. doi:10.1001/archderm.137.1.19