Atypical adult-onset Henoch-Schönlein purpura in a female patient from Bangladesh: Post-streptococcal vasculitis without IgA deposition – A case report

Medical Reports Pub Date : 2025-09-02 DOI:10.1016/j.hmedic.2025.100359

Zahin Shahriar, Sakib Abrar , Soumik Roy, Shaimul Reza, Fabiha Rahman, Tushar Kanti Bhadra

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Abstract

Adult-onset Henoch-Schönlein Purpura (HSP), although much less common than in children, tends to display a much more sinister clinical course. This case is about a 35-year-old female who presented with polyarthritis, abdominal pain, and purpuric rash- symptoms aligning with those of IgA vasculitis. Furthermore, she had a history of a recent sore throat, an elevated antistreptolysin O (ASO) titer, and her skin biopsy demonstrated leuko-cytoclastic vasculitis-all suggestive of post-streptococcal origin. However, the Direct Immunofluorescence (DIF) test results were negative for the expected IgA deposits. Adult-onset HSP exhibits rather diverse clinical manifestations that often defy the textbook descriptions; noticeable patient improvement after initiation of corticosteroid therapy underscores the importance of its early recognition. Adult HSP, therefore, warrants a high degree of diagnostic scrutiny and an eye for the culprit infectious agents.

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孟加拉国女性患者的非典型成人发病Henoch-Schönlein紫癜：链球菌感染后血管炎无IgA沉积- 1例报告

成人发病Henoch-Schönlein紫癜（HSP），虽然比儿童少得多，但往往表现出更险恶的临床过程。这个病例是一个35岁的女性，她表现为多关节炎、腹痛和紫癜性皮疹，这些症状与IgA血管炎的症状一致。此外，她最近有喉咙痛史，抗溶血素O （ASO）滴度升高，皮肤活检显示白细胞分裂性血管炎，所有这些都提示链球菌感染后的起源。然而，直接免疫荧光（DIF）检测结果对预期的IgA沉积呈阴性。成人发病HSP表现出相当多样化的临床表现，往往无视教科书的描述；在皮质类固醇治疗开始后，明显的患者改善强调了早期识别的重要性。成人热休克，因此，保证了高度的诊断审查和眼睛的罪魁祸首的传染性病原体。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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