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급성 신부전을 동반한 성인 Henoch-Schonlein 자반증 1예
김석민 ( Seok Min Kim ),장경애 ( Kyung Ae Chang ),정선영 ( Sun Young Jung ),박찬서 ( Chan Soh Park ),박종원 ( Jong Won Park ),도준영 ( Jun Young Do ),김용진 ( Yong Jin Kim ),윤경우 ( Kyung Woo Yoon ) 영남대학교 기초/임상의학연구소 2008 Yeungnam University Journal of Medicine Vol.25 No.1
Henoch-Schonlein purpura (HSP) is a leukocytoclastic vasculitis of small vessels with deposition of IgA, commonly resulting in skin, joint, gastrointestinal, and kidney involvement. HSP is an uncommon disorder in adults and accounts for 0.6% to 2% of adult nephropathy. We report a case of HSP with acute renal failure successfully treated with corticosteroid. In this case, the patient presented with vasculitic purpuric rash on lower extremity, arthralgia in the wrist, abdominal pain, hematochezia, oliguria and azotemia. Abdominal CT showed wall thickening of the small and large bowels. Skin biopsy revealed leukocytoclastic vasculitis. Percutaneous renal biopsy showed no crescent formation, but mesangial IgA and C3 deposits were observed by immunofluorescence. The patient was treated with corticosteroid (1mg/kg per day) and hemodialysis. After treatment, renal function improved and purpuric lesion, arthralgia and abdominal pain disappeared. Thus, when adults present with purpuric rash and rapidly progressive glomerulonephritis (RPGN), HSP should be a diagnostic consideration.