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Respirol Case Rep. 2014 Dec;2(4):138-40. doi: 10.1002/rcr2.78. Epub 2014 Sep 23.

Henoch-Schonlein purpura in mesothelioma.

Author information

1
Department of Respiratory Medicine, Sir Charles Gairdner Hospital Perth, Western Australia, Australia.
2
PathWest Laboratory Medicine, QE II Med Ctr Perth, Western Australia, Australia.
3
Department of Renal Medicine, Sir Charles Gairdner Hospital Perth, Western Australia, Australia.
4
Centre of Asthma, Allergy and Respiratory Research, School of Medicine and Pharmacology, University of Western Australia Perth, Western Australia, Australia.

Abstract

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.

KEYWORDS:

Henoch–Schonlein purpura; mesothelioma; pleura; renal failure; vasculitis

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