Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
권호 표지
DOI QR코드

DOI QR Code

A Case of Henoch-Schönlein Purpura Developed during Treatment of Lung Cancer

원발성 폐암 치료 중 발생한 Henoch-Schönlein Purpura 1예

  • Kang, Min Soo (Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences) ;
  • Noh, Geum Yeub (Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences) ;
  • Jang, Young Joo (Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences) ;
  • Cho, Soo Youn (Department of Pathology, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences) ;
  • Rhim, Kyung Jin (Department of Dermatology, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences) ;
  • Noh, Hee Sun (Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences) ;
  • Kim, Hye-Ryoun (Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences) ;
  • Kim, Cheol Hyeon (Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences) ;
  • Lee, Jae Cheol (Department of Internal Medicine, Korea Cancer Center Hospital, Korea Institute of Radiological & Medical Sciences)
  • Received : 2009.08.04
  • Accepted : 2009.08.19
  • Published : 2009.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Henoch-$Sch\ddot{o}nlein$ Purpura (HSP) is a systemic vasculitis involving small vessels with the deposition of immune complexes containing IgA and C3, which is characterized by associated skin, joint, renal, and gastrointestinal manifestations. Although there were several causes such as autoimmunity, infection, and drugs, it also can be presented as a form of vasculitidies associated with malignancies. We report a case of HSP developed during treatment for non-small cell lung cancer in a 66-year-old man. Multiple purpuric skin lesions occurred in both legs after the first cycle of chemotherapy, which was diagnosed as HSP by clinical and pathologic examinations. Due to the itching sensation, topical steroid was applied and the patient was improved 3 weeks later without a scheduled change in chemotherapy.

Keywords

References

  1. Lawee D. Atypical clinical course of Henoch-Schonlein purpura. Can Fam Physician 2008;54:1117-20
  2. Dillon MJ. Henoch-Sch$\ddot{o}$nlein purpura: recent advances. Clin Exp Rheumatol 2007;25:S66-8
  3. Kim ID, Lee SG, Lee HJ, Jo WS, Choi YJ, Shin HJ, et al. A case of Henoch-Sch$\ddot{o}$nlein purpura associated with diffuse large B cell lymphoma. Korean J Hematol 2007; 42:162-6 https://doi.org/10.5045/kjh.2007.42.2.162
  4. Zurada JM, Ward KM, Grossman ME. Henoch-Sch$\ddot{o}$nlein purpura associated with malignancy in adults. J Am Acad Dermatol 2006;55:S65-70 https://doi.org/10.1016/j.jaad.2005.10.011
  5. Mitsui H, Shibagaki N, Kawamura T, Matsue H, Shimada S. A clinical study of Henoch-Sch$\ddot{u}$nlein Purpura associated with malignancy. J Eur Acad Dermatol Venereol 2009;23:394-401 https://doi.org/10.1111/j.1468-3083.2008.03065.x
  6. Mills JA, Michel BA, Bloch DA, Calabrese LH, Hunder GG, Arend WP, et al. The American College of Rheumatology 1990 criteria for the classification of Henoch-Sch$\ddot{o}$nlein purpura. Arthritis Rheum 1990;33:1114-21 https://doi.org/10.1002/art.1780330809
  7. Fain O, Guillevin L, Kaplan G, Sicard D, Lemaire V, Godeau P, et al. Vasculitis and neoplasms: 14 cases. Ann Med Interne (Paris) 1991;142:486-504
  8. Blanco R, Mart$\acute{i}$nez-Taboada VM, Rodr$\acute{i}$guez-Valverde V, Garc$\acute{i}$a-Fuentes M. Cutaneous vasculitis in children and adults: associated diseases and etiologic factors in 303 patients. Medicine (Baltimore) 1998;77:403-18 https://doi.org/10.1097/00005792-199811000-00007
  9. Fain O, Hamidou M, Cacoub P, Godeau B, Wechsler B, Paries J, et al. Vasculitides associated with malignancies: analysis of sixty patients. Arthritis Rheum 2007;57:1473-80 https://doi.org/10.1002/art.23085
  10. Kurzrock R, Cohen PR, Markowitz A. Clinical manifestations of vasculitis in patients with solid tumors: a case report and review of the literature. Arch Intern Med 1994;154:334-40 https://doi.org/10.1001/archinte.154.3.334
  11. Ng JP, Murphy J, Chalmers EM, Hogg RB, Cumming RL, Peebles S. Henoch-Schönlein purpura and Hodgkin’s disease. Postgrad Med J 1988;64:881-2 https://doi.org/10.1136/pgmj.64.757.881
  12. Mitchell DM, Hoffbrand BI. Relapse of Henoch-Sch$\ddot{o}$nlein disease associated with lung carcinoma. J R Soc Med 1979;72:614-5 https://doi.org/10.1177/014107687907200814
  13. Lee C, Gianos M, Klaustermeyer WB. Diagnosis and management of hypersensitivity reactions related to common cancer chemotherapy agents. Ann Allergy Asthma Immunol 2009;102:179-87; quiz 187-9, 222 https://doi.org/10.1016/S1081-1206(10)60078-6
  14. Weidmann B, Mulleneisen N, Bojko P, Niederle N. Hypersensitivity reactions to carboplatin. Report of two patients, review of the literature, and discussion of diagnostic procedures and management. Cancer 1994;73:2218-22 https://doi.org/10.1002/1097-0142(19940415)73:8<2218::AID-CNCR2820730830>3.0.CO;2-1
  15. Aktas B, Topcuoglu P, Kurt OK, Ensari A, Demirer T. Severe henoch-Schönlein purpura induced by cytarabine. Ann Pharmacother 2009;43:792-3 https://doi.org/10.1345/aph.1L608