Henoch-Schönlein purpura in the third trimester of pregnancy

Biochem Med (Zagreb). 2018 Feb 15;28(1):010801. doi: 10.11613/BM.2018.010801. Epub 2018 Jan 10.

Abstract

Henoch-Schönlein purpura (HSP) is an IgA-mediated small vessels' vasculitis that affects the skin, intestines and kidneys. Pregnancy has been reported as an exacerbating factor. We present the case of a 24-year-old primigravida with HSP that occurred in the third trimester and lasted up to the end of the successful delivery. She had pruritic maculopapular exanthema on her legs. Biopsy of a cutaneous lesion was performed for histopathologic features and direct immunofluorescence (DIF) for the presence of perivascular IgA deposition. Histopathology of the cutaneous lesion confirmed leukocytoclastic vasculitis. A DIF examination of the skin lesion confirmed deposits of fibrinogen in the small blood vessel walls. Six weeks following delivery, the skin lesions almost completely disappeared. Control laboratory findings were normal. This case of HSP might have been primarily associated with a preceding respiratory infection but this should first be carefully investigated due to a possible severe immunological disease in the patient's background requiring special attention since nephrotic symptoms may occur.

Keywords: Henoch-Schönlein purpura; glomerulonephritis; leukocytoclastic vasculitis; preeclampsia; pregnancy.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use
  • Diagnosis, Differential
  • Female
  • Fluorescent Antibody Technique, Direct
  • Humans
  • IgA Vasculitis / diagnosis*
  • IgA Vasculitis / drug therapy
  • IgA Vasculitis / pathology
  • Immunoglobulin A / analysis
  • Pregnancy
  • Pregnancy Complications / diagnosis
  • Pregnancy Trimester, Third
  • Pruritus / complications
  • Pruritus / diagnosis
  • Young Adult

Substances

  • Adrenal Cortex Hormones
  • Immunoglobulin A

Supplementary concepts

  • Pruritic urticarial papules plaques of pregnancy