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A Case of Henoch-Schonlein Purpura Nephritis Complicating Encephalopathy Accompanied by Hypertension and Cerebral Vasculitis  

Choi, Hee Ra (Department of Pediatrics, College of Medicine, Gyeongsang National University)
Kim, Eo Jin (Department of Pediatrics, College of Medicine, Gyeongsang National University)
Choi, Myoung Bum (Department of Pediatrics, College of Medicine, Gyeongsang National University)
Lim, Jae Young (Department of Pediatrics, College of Medicine, Gyeongsang National University)
Park, Chan Hoo (Department of Pediatrics, College of Medicine, Gyeongsang National University)
Woo, Hyang Ok (Department of Pediatrics, College of Medicine, Gyeongsang National University)
Youn, Hee Sang (Department of Pediatrics, College of Medicine, Gyeongsang National University)
Publication Information
Clinical and Experimental Pediatrics / v.46, no.10, 2003 , pp. 1040-1043 More about this Journal
Abstract
Henoch-Shonlein purpura(HSP) is a systemic small-vessel vasculitis that primarily affects the skin, gastrointestinal tract, joints, and kidneys. The nervous system may be involved, less commonly than other organs. When the central nervous system(CNS) was involved, headache, changes in mental status, seizures, and focal neurologic deficits have been reported. Hypertension, uremic encephalopathy, metabolic abnomalities, electrolyte abnormalities, or cerebral vasculitis were suggested as possible causes of the neurologic manifestation. Diagnosis of vasculitic involvement of CNS is difficult. Magnetic resonance imaging of the brain is the modality of choice for the evaluation of the CNS disease. Steroid or plasmapheresis are used in treatment of cerebral vasculitis. We experienced a case of 9-year-old boy who had presented with Henoch-Schonlein purpura nephritis complicating encephalopathy accompanied by hypertension and cerebral vasculitis. Brain MRI showed multiple small nodular-linear pattern enhancing lesions in whole cerebral hemispheres and focal increased T2 signal in the right basal ganglia. We used intravenous immunoglobulin in treatment of cerebral vasculitis. We report this case with a brief review of related literature.
Keywords
Henoch-Schonlein purpura nephritis; Encephalopathy; Hypertension; Cerebral vasculitis; Intravenous immunoglobulin;
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