All issues > Volume 46(10); 2003

Case Report

J Korean Pediatr Soc. 2003;46(10):1040-1043. Published online October 15, 2003.

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

Hee Ra HR Choi¹, Eo Jin EJ Kim¹, Myoung Bum MB Choi¹, Jae Young JY Lim¹, Chan Hoo CH Park¹, Hyang Ok HO Woo¹, Hee Sang HS Youn¹

¹Department of Pediatrics, College of Medicine, Gyeongsang National University, Chinju, Korea

Correspondence Myoung Bum MB Choi ,Email: choimb@nongae.gsnu.ac.kr

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