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Muacevic A, Adler JR, Haddad R. Drug-Induced IgA Vasculitis in an Adult. Cureus 2023; 15:e34270. [PMID: 36855485 PMCID: PMC9968465 DOI: 10.7759/cureus.34270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2023] [Indexed: 01/29/2023] Open
Abstract
A 65-year-old man developed palpable purpuric papules and plaques on his lower extremities, which quickly spread to his trunk and upper extremity after being prescribed cephalexin and doxycycline in the emergency room. Here, we define the details of a textbook-like presentation of IgA vasculitis, formerly referred to as Henoch-Schönlein purpura, in an adult.
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Zhang L, Lin Q, Jiang L, Wu M, Huang L, Quan W, Li X. Increased circulating innate lymphoid cell (ILC)1 and decreased circulating ILC3 are involved in the pathogenesis of Henoch-Schonlein purpura. BMC Pediatr 2022; 22:201. [PMID: 35413831 PMCID: PMC9003988 DOI: 10.1186/s12887-022-03262-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 04/01/2022] [Indexed: 11/30/2022] Open
Abstract
Background Innate lymphoid cell (ILC) dysfunction is involved in numerous immune diseases, but this has not been demonstrated in Henoch-Schonlein purpura (HSP). This study aimed to investigate whether ILC dysfunction or imbalance participate in the pathogenesis of HSP. Methods This was a prospective study in patients with HSP who were hospitalized at the Children’s Hospital of Soochow University from June to December 2019. Age- and sex-matched controls were also enrolled. ILC subsets and lymphocyte subpopulations were determined by flow cytometry. The transmission immune turbidimetric method also facilitated the exploration of correlations between ILC subset frequency and lymphocyte subpopulation, as well as serum IgA in HSP patients. Results Fifty-one patients with HSP and 22 control patients were included. There were no differences in age and sex between the two groups. Compared with controls, patients with HSP had higher ILCs in relation to lymphocytes (P = 0.036), higher ILCs in relation to PBMCs (P = 0.026), higher ILC1s (P < 0.001), lower ILC3s (P < 0.05), and higher ILC1/ILC3 ratio (P < 0.001). Sixteen patients underwent routine therapy combined with methylprednisolone for 7–10 days; ILC1s were significantly decreased (P < 0.001) and ILC3s were increased (P = 0.033), and ILC1/ILC3 was significantly decreased (P < 0.001). Compared with the controls, the ratios of ILCs/lymphocytes and ILCs/PBMC were higher in patients in the arthritis and mixed groups (all P < 0.05). ILC1 were elevated in the purpura, arthritis, abdominal, and mixed groups (P = 0.027, P = 0.007, P < 0.001, and P < 0.001, respectively). ILC1/ILCs were positively correlated with CD3 + CD8 + T lymphocytes (r = 0.3701, P = 0.0075). The level of IgA did not correlate with ILCs. Conclusions Higher circulating ILC1s and lower circulating ILC3s appear to be involved in the pathogenesis of HSP. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-022-03262-w.
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Affiliation(s)
- Lili Zhang
- Department of Nephrology, Children's Hospital of Soochow University, No. 92, Zhong Nan Street, Industrial Park, Suzhou, 215003, Jiangsu, China.,Department of Pediatrics, Affiliated Hospital of Yangzhou University, Yangzhou, 225000, Jiangsu, China
| | - Qiang Lin
- Department of Nephrology, Children's Hospital of Soochow University, No. 92, Zhong Nan Street, Industrial Park, Suzhou, 215003, Jiangsu, China
| | - Lijun Jiang
- Department of Neonatology, Affiliated Hospital of Yangzhou University, Yangzhou, 225000, Jiangsu, China
| | - Mingfu Wu
- Department of Neonatology, Affiliated Hospital of Yangzhou University, Yangzhou, 225000, Jiangsu, China
| | - Linlin Huang
- Department of Pediatric Intensive Care Unit, Children's Hospital of Soochow University, Suzhou, 215003, Jiangsu, China
| | - Wei Quan
- Department of Nephrology, Children's Hospital of Soochow University, No. 92, Zhong Nan Street, Industrial Park, Suzhou, 215003, Jiangsu, China
| | - Xiaozhong Li
- Department of Nephrology, Children's Hospital of Soochow University, No. 92, Zhong Nan Street, Industrial Park, Suzhou, 215003, Jiangsu, China.
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Li C, Wang ZB. Clinical application of compound Glycyrrhizin tablets in the treatment of patients with Simplex Henoch-Schonlein Purpura and its effect on immune function. Pak J Med Sci 2022; 38:271-275. [PMID: 35035438 PMCID: PMC8713233 DOI: 10.12669/pjms.38.1.4609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/27/2021] [Accepted: 09/08/2021] [Indexed: 11/24/2022] Open
Abstract
Objectives: To investigate the curative effect of Compound Glycyrrhizin Tablets in the adjuvant treatment of simplex Henoch-Schonlein purpura and its influence in improving immune function. Methods: In this retrospective study design was used in this study. Eighty newly diagnosed patients with purpura simplex who visited the outpatient department of Baoding First Central Hospital from June 2017 to February 2020 were included. They were randomly divided into treatment group and control group. The two groups were provided with the same conventional comprehensive treatment. Patients in the treatment group received oral administration of Compound Glycyrrhizin Tablets on the basis of conventional treatment. The clinical efficacy of the treatment group and the control group were compared according to the time and effect of purpura regression, followed by the comparison of changes of T cell subsets before and after treatment. Results: The total effective rate of the treatment group was 92.5%, which was higher than that of the control group (77.5%) (P < 0.05). The purpura subsidence time of effective patients in treatment group was shorter than that in control group (P < 0.05). There was no significant difference in lymphocyte subsets between the treatment group and the control group before treatment. After treatment, the proportion of CD4+ cells and CD4+/CD8+ cells in the treatment group were obviously higher than that in the control group, and the count of CD8+ cells was evidently lower than that in the control group (P < 0.05). Conclusions: Compound Glycyrrhizin is effective in the adjuvant treatment of simplex Henoch-Schonlein purpura without obvious adverse reactions, which is valuable for clinical application as an adjuvant.
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Affiliation(s)
- Chao Li
- Chao Li, Department of Hematology, Beijing Aerospace General Hospital, Beijing, 100076, P.R. China
| | - Zhi-Bin Wang
- Zhi-bin Wang2 Department of Hematology, Baoding First Central Hospital, Baoding, Hebei, 071000, P.R.China
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Mazumder S, Ma M, Champigny M, Adeyemo A. A Case of Adult-onset Henoch-Schönlein Purpura Triggered by Fire Ants. Cureus 2020; 12:e7341. [PMID: 32313782 PMCID: PMC7164697 DOI: 10.7759/cureus.7341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Adult-onset IgA vasculitis, also known as Henoch-Schönlein purpura (HSP), is a rare disease that often presents with a non-blanchable, purpuric rash and can simultaneously affect the gastrointestinal, renal and musculoskeletal systems. The etiology of HSP is unknown. It can be triggered by any entity that creates an immunological insult, including medications, infections and vaccines. We describe a unique case of an adult woman who presented with HSP after experiencing multiple insect bites from fire ants and mosquitos while traveling overseas.
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Affiliation(s)
- Samia Mazumder
- Dermatology, Wayne State University School of Medicine, Detroit, USA
| | - Mia Ma
- Surgery, Wayne State University School of Medicine, Detroit, USA
| | - Michele Champigny
- Surgery, Beaumont Hospital, Dearborn, USA.,Surgery, Beaumont Hospital, Trenton, USA
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