B6-035 Henock-Shoenlein Purpura Flashcards
small vessel vasculitis preceded by viral respiratory infection
Henoch-Shonlein purpura (IgA vasculitis)
IgA dominant immune deposits
Henoch-Shonlein purpura (IgA vasculitis)
Henoch-Shonlein purpura (IgA vasculitis) must have palpable purpura without […]
thrombocytopenia
where on the body does Henoch-Shonlein purpura (IgA vasculitis) concentrate? [2]
legs
buttocks
what kinds of GI involvement can Henoch-Shonlein purpura (IgA vasculitis) present with?
-abdominal pain
-melena or bloody stools
-intussusception
Kidney involvement of Henoch-Shonlein purpura (IgA vasculitis) is identified with […] or […] on urinalysis
blood
protein
treatment for Henoch-Shonlein purpura (IgA vasculitis)
symptom control - analgesia
pulse dose IV methylprednisone followed by PO steroids with long taper
serial monitoring of kidney function
small vessel vasculitis affecting primarily the glomerular and pulmonary capillaries
anti-GBM (Goodpasture)
anti-GBM (Goodpasture) is characterized by antibodies directed against
basement membrane
80-90% of patients present with glomerulonephritis
50% present with lung hemorrhage
anti-GBM (Goodpasture)
type 2 HS
linear deposits of IgG along the GBM
anti-GBM (Goodpasture)
significant crescent formation on histopathology of the kidney
anti-GBM (Goodpasture)
**HSP has some, but not nearly as significant
treatment for anti-GBM (Goodpasture)
plasmapheresis
corticosteroids (much longer treatment time than HSP)
type 2 HS
type III hypersensitivity where protein antigens from the drug binds antibody
drug induced vasculitis
biopsy of skin rash shows neutrophils around small vessel
drug induced vasculitis
high ESR
low C3/C4
normal urinalysis
drug induced vasculitis
treatment for drug induced vasculitis
stop drug, replace as applicable
most common initial symptom of IgA vasculitis
skin findings
most helpful initial test in evaluation of HSP
CBC
**to evaluate thrombocytopenia
biggest concern of HSP is developing […] involvment
kidney
poor prognostic indicators of HSP [3]
older patient
hypertension
crescents
treatment of choice for HSP
high dose pulse methylprednisone followed by long taper
treatment of choice for drug induced vaculitis
stop offending agent
replace with different class as needed
typical symptoms of HSP [3]
skin rash
arthritis
hematuria
HSP patients most commonly experience arthritis in the
ankles
can be migratory
most likely chronic symptom of HSP
kidney involvement
1/3 of HSP patients experience
relapse
**usually only involving skin
without treatment, HSP patients will
spontaneously recover in 4-6 weeks
**corticosteroids improve symptoms sooner
what is the pathological mechanism of HSP?
IgA immune complexes cause a complement and Fc receptor mediated activation of inflammatory cells
HSP is mediated by […] immune complexes
IgA
type 3 HS
[…] MUST be excluded prior to diagnosis of HSP
thrombocytopenia
does relapse occur in drug induced vasculitis?
no, only with re-exposure
most patients with drug induced vasculitis have full resolution of symptoms within
1-2 weeks
are steroids used to treat drug induced vasculitis?
no
