Associates' Presentations
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A case presentation of Henoch-Schonlein purpura and pancreatitis.
Bryan P. Rolph, M.D., (Associate), Gundersen Medical Foundation/Lutheran Hospital, LaCrosse, Wisconsin.
A 25-year-old male from a small Wisconsin town began having knee stiffness after being treated with amoxicillin for pharyngitis. He then noted a petichial rash on his legs, which soon spread to many parts of his body. Next, his elbows and wrists began to swell and he was subsequently admitted for further evaluation.
Soon after admission he began having abdominal pain and melena. Laboratory investigation showed that the patient's amylase and lipase were elevated, suggesting pancreatitis. Further testing narrowed the differential diagnosis and a skin biopsy was performed which showed IgA deposition around the arterioles in the dermis. This confirmed the suspected diagnosis of Henoch-Schonlein Purpura (HSP).
HSP is a vasculitic disease of unknown cause which most commonly afflicts children. It can affect many organs, but involvement of the pancreas is quite rare, and this is only the sixth reported case.
Treatment generally involves supportive care. However, with cases involving the abdominal viscera, steroids have been shown to be beneficial in the prevention of complications.
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