Skip to main content

A case of Henoch-Schönlein purpura associated with posterior reversible encephalopathy and review of litereature

Introduction

Henoch-Schönlein purpura (HSP) is a vasculitis that involves small vessels and seen in children predominantly. Main symptoms are purpuric rashes on body, especially on lower extremities, arthralgia, abdominal pain, and nephritis. Uncommonly, nervous system can be involved.

Objectives

PRES can occur in HSP infrequently. Here we will review our case, a first reported Korean case, and compare with published cases to find out which symptoms and signs should be aware.

Methods

First, our case is reviewed retrospectively by electrical medical record. And then, we searched Pubmed database, terms including HSP, PRES, RPLS, and encephalopathy. We compared collected cases and our case.

Results

A 8-year-old girl visited our hospital complaining abdominal pain and purpuric rash on lower extremities and buttock. On hospital day 7, there were two brief events of generalized tonic-clonic seizure. She complained dizziness and blurred vision. Brain MRI demonstrated increased signal intensity in the cortex and subcortical white matter, in the parietooccipital area, and impression was PRES. She was discharged on day 19 without any complication. Table 1.

Table 1 Table 1

Conclusion

In HSP patients, hemodynamic change due to severe hypertension and renal insufficiency, and CNS vasculitis can cause PRES. JI Shin suggests IL-6 and VEGF can play a role in this situation. Neurological involvement is not common in HSP. But when patients complain headache or blurred vision, it can be manifestation of CNS lesion, including PRES. Adequate assessment and manage should be performed to avoid neurologic sequela.

Disclosure of interest

None declared

Author information

Affiliations

Authors

Corresponding author

Correspondence to Kyu Yeun Kim.

Rights and permissions

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Kim, K.Y., Jung, M.K., Kim, K.H. et al. A case of Henoch-Schönlein purpura associated with posterior reversible encephalopathy and review of litereature. Pediatr Rheumatol 12, P358 (2014). https://doi.org/10.1186/1546-0096-12-S1-P358

Download citation

Keywords

  • Vasculitis
  • Nephritis
  • Purpura
  • Severe Hypertension
  • Neurologic Sequela