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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6 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 languageEnglish
Pages (from-to)1755-1761
Number of pages7
JournalInternal Medicine
Volume49
Issue number16
DOIs
Publication statusPublished - 2010 Sep 7

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Keywords

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

ASJC Scopus subject areas

  • Internal Medicine

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