A case of IgA-related enteropathy complicated with gastrointestinal bleeding and progressive IgA nephropathy: A possible variant Henoch-Schönlein purpura?

Shoko Nakamura; Tadakazu Hisamatsu; Jun Kikuchi; Masayuki Adachi; Yoshiyuki Yamagishi; Hiroyuki Imaeda; Naoki Hosoe; Makoto Naganuma; Hirotoshi Ebinuma; Susumu Okamoto; Takanori Kanai; Haruhiko Ogata; Hironari Hanaoka; Yoshiaki Furuya; Yoshinaga Kawano; Kanako Bokuda; Hiroyuki Sasamura; Hiroshi Uchida; Takashi Endo; Akinori Hashiguchi; Kaori Kameyama; Makio Mukai; Toshifumi Hibi

doi:10.2169/internalmedicine.49.3678

A case of IgA-related enteropathy complicated with gastrointestinal bleeding and progressive IgA nephropathy: A possible variant Henoch-Schönlein purpura?

Shoko Nakamura, Tadakazu Hisamatsu, Jun Kikuchi, Masayuki Adachi, Yoshiyuki Yamagishi, Hiroyuki Imaeda, Naoki Hosoe, Makoto Naganuma, Hirotoshi Ebinuma, Susumu Okamoto, Takanori Kanai, Haruhiko Ogata, Hironari Hanaoka, Yoshiaki Furuya, Yoshinaga Kawano, Kanako Bokuda, Hiroyuki Sasamura, Hiroshi Uchida, Takashi Endo, Akinori HashiguchiKaori Kameyama, Makio Mukai, Toshifumi Hibi

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8 Citations (Scopus)

Abstract

Here, we report an adult patient with IgA-related enteropathy complicated with massive intestinal bleeding and acute renal failure, but without skin lesions. Surgical resection of the small intestine and steroid pulse therapy was performed. Histopathology revealed significant deposition of IgA and C3 in the small vessels of the intestine and the kidney mesangium. Although skin purpura was absent, the histopathology and clinical manifestations suggested that the pathophysiology was similar to Henoch-Schönlein purpura (HSP), implying IgA-related enteropathy as a subclass of HSP. Retrospective analysis indicates that terminal ileum lesions may be a poor prognostic indicator.

Original language	English
Pages (from-to)	1755-1761
Number of pages	7
Journal	Internal Medicine
Volume	49
Issue number	16
DOIs	https://doi.org/10.2169/internalmedicine.49.3678
Publication status	Published - 2010

Keywords

Crescentic glomerulonephritis
Gastrointestinal bleeding
Henoch- Schönlein purpura
IgA related enteropathy
Steroid pulse therapy

ASJC Scopus subject areas

Internal Medicine

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Nakamura, S., Hisamatsu, T., Kikuchi, J., Adachi, M., Yamagishi, Y., Imaeda, H., Hosoe, N., Naganuma, M., Ebinuma, H., Okamoto, S., Kanai, T., Ogata, H., Hanaoka, H., Furuya, Y., Kawano, Y., Bokuda, K., Sasamura, H., Uchida, H., Endo, T., ... Hibi, T. (2010). A case of IgA-related enteropathy complicated with gastrointestinal bleeding and progressive IgA nephropathy: A possible variant Henoch-Schönlein purpura? Internal Medicine, 49(16), 1755-1761. https://doi.org/10.2169/internalmedicine.49.3678

Nakamura, S, Hisamatsu, T, Kikuchi, J, Adachi, M, Yamagishi, Y, Imaeda, H, Hosoe, N, Naganuma, M, Ebinuma, H, Okamoto, S, Kanai, T, Ogata, H, Hanaoka, H, Furuya, Y, Kawano, Y, Bokuda, K, Sasamura, H, Uchida, H, Endo, T, Hashiguchi, A, Kameyama, K, Mukai, M & Hibi, T 2010, 'A case of IgA-related enteropathy complicated with gastrointestinal bleeding and progressive IgA nephropathy: A possible variant Henoch-Schönlein purpura?', Internal Medicine, vol. 49, no. 16, pp. 1755-1761. https://doi.org/10.2169/internalmedicine.49.3678

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title = "A case of IgA-related enteropathy complicated with gastrointestinal bleeding and progressive IgA nephropathy: A possible variant Henoch-Sch{\"o}nlein purpura?",

abstract = "Here, we report an adult patient with IgA-related enteropathy complicated with massive intestinal bleeding and acute renal failure, but without skin lesions. Surgical resection of the small intestine and steroid pulse therapy was performed. Histopathology revealed significant deposition of IgA and C3 in the small vessels of the intestine and the kidney mesangium. Although skin purpura was absent, the histopathology and clinical manifestations suggested that the pathophysiology was similar to Henoch-Sch{\"o}nlein purpura (HSP), implying IgA-related enteropathy as a subclass of HSP. Retrospective analysis indicates that terminal ileum lesions may be a poor prognostic indicator.",

keywords = "Crescentic glomerulonephritis, Gastrointestinal bleeding, Henoch- Sch{\"o}nlein purpura, IgA related enteropathy, Steroid pulse therapy",

author = "Shoko Nakamura and Tadakazu Hisamatsu and Jun Kikuchi and Masayuki Adachi and Yoshiyuki Yamagishi and Hiroyuki Imaeda and Naoki Hosoe and Makoto Naganuma and Hirotoshi Ebinuma and Susumu Okamoto and Takanori Kanai and Haruhiko Ogata and Hironari Hanaoka and Yoshiaki Furuya and Yoshinaga Kawano and Kanako Bokuda and Hiroyuki Sasamura and Hiroshi Uchida and Takashi Endo and Akinori Hashiguchi and Kaori Kameyama and Makio Mukai and Toshifumi Hibi",

year = "2010",

doi = "10.2169/internalmedicine.49.3678",

language = "English",

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T1 - A case of IgA-related enteropathy complicated with gastrointestinal bleeding and progressive IgA nephropathy

T2 - A possible variant Henoch-Schönlein purpura?

AU - Nakamura, Shoko

AU - Hisamatsu, Tadakazu

AU - Kikuchi, Jun

AU - Adachi, Masayuki

AU - Yamagishi, Yoshiyuki

AU - Imaeda, Hiroyuki

AU - Hosoe, Naoki

AU - Naganuma, Makoto

AU - Ebinuma, Hirotoshi

AU - Okamoto, Susumu

AU - Kanai, Takanori

AU - Ogata, Haruhiko

AU - Hanaoka, Hironari

AU - Furuya, Yoshiaki

AU - Kawano, Yoshinaga

AU - Bokuda, Kanako

AU - Sasamura, Hiroyuki

AU - Uchida, Hiroshi

AU - Endo, Takashi

AU - Hashiguchi, Akinori

AU - Kameyama, Kaori

AU - Mukai, Makio

AU - Hibi, Toshifumi

PY - 2010

Y1 - 2010

N2 - Here, we report an adult patient with IgA-related enteropathy complicated with massive intestinal bleeding and acute renal failure, but without skin lesions. Surgical resection of the small intestine and steroid pulse therapy was performed. Histopathology revealed significant deposition of IgA and C3 in the small vessels of the intestine and the kidney mesangium. Although skin purpura was absent, the histopathology and clinical manifestations suggested that the pathophysiology was similar to Henoch-Schönlein purpura (HSP), implying IgA-related enteropathy as a subclass of HSP. Retrospective analysis indicates that terminal ileum lesions may be a poor prognostic indicator.

AB - Here, we report an adult patient with IgA-related enteropathy complicated with massive intestinal bleeding and acute renal failure, but without skin lesions. Surgical resection of the small intestine and steroid pulse therapy was performed. Histopathology revealed significant deposition of IgA and C3 in the small vessels of the intestine and the kidney mesangium. Although skin purpura was absent, the histopathology and clinical manifestations suggested that the pathophysiology was similar to Henoch-Schönlein purpura (HSP), implying IgA-related enteropathy as a subclass of HSP. Retrospective analysis indicates that terminal ileum lesions may be a poor prognostic indicator.

KW - Crescentic glomerulonephritis

KW - Gastrointestinal bleeding

KW - Henoch- Schönlein purpura

KW - IgA related enteropathy

KW - Steroid pulse therapy

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A case of IgA-related enteropathy complicated with gastrointestinal bleeding and progressive IgA nephropathy: A possible variant Henoch-Schönlein purpura?

Abstract

Keywords

ASJC Scopus subject areas

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