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Case Reports in Medicine
Volume 2016, Article ID 7890379, 3 pages
http://dx.doi.org/10.1155/2016/7890379
Case Report

Henoch Schonlein Purpura as a Cause of Renal Failure in an Adult

1Department of Internal Medicine, Creighton University Medical Center, Omaha, NE, USA
2Department of Family Medicine, Creighton University Medical Center, Omaha, NE, USA
3Department of Pathology, Creighton University Medical Center, Omaha, NE, USA

Received 24 July 2016; Accepted 23 August 2016

Academic Editor: Thomas R. Chauncey

Copyright © 2016 Shweta Kukrety et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Henoch Schonlein purpura (HSP) is an immune mediated disease associated Immunoglobulin A (IgA) deposition within the affected organs. While the disease is commonly seen in the pediatric age group, it is rarely seen in adults. We report the case of a 93-year-old Caucasian lady who presented with nonthrombocytopenic purpuric rash and acute kidney injury after an episode of bronchitis. Rapid and progressive deterioration of renal function prompted a kidney biopsy, which showed findings consistent with IgA nephropathy confirming the diagnosis of HSP. The patient was treated with high dose intravenous methylprednisolone followed by oral prednisone; however, her kidney disease progressed to end stage renal disease requiring hemodialysis. HSP is usually a self-limiting disease in children. However, adults are at an increased risk of severe renal involvement including end stage renal disease. Purpuric skin rash with renal involvement should raise suspicion for HSP. This is the oldest known patient with HSP.