IgA Vasculitis (Henoch-Schönlein purpura) in the Elderly 老年过敏性紫癜一例
IgA vasculitis, also known as Henoch-Schönlein purpura (HSP), predominantly impacts children but can also manifest in adults. Its hallmark features encompass abdominal and joint discomfort, a distinctive rash characterized by small, red to purple, slightly elevated areas, and kidney involvement that can result in discolored urine resembling tea or coffee.
Case Report
A 65-year-old woman presented with palpable purpura lesions on her lower extremities, akin to minuscule raised bruises. She reported experiencing abdominal pain exacerbated by meals but alleviated with bowel movements. The patient disclosed a five-year history of hypertension and no other underlying medical conditions. Our preliminary diagnosis was Henoch-Schönlein purpura (HSP), and we recommended consulting a gastroenterologist for abdominal pain assessment via imaging studies. The patient expressed a desire to explore herbal Traditional Chinese Medicine (TCM) remedies to manage her skin lesions and abdominal discomfort while awaiting her CT scan appointment.
The patient was prescribed a meticulously tailored herbal medicinal formula designed to address her distinctive clinical presentation. Over a span of four months, the cutaneous lesions exhibited gradual regression, with complete resolution achieved by the fourth month (Figure 1), additionally her abdominal pain is gone. Patient did not proceed gastroenterogly CT scan appointment as her symptoms is fully resolved.
Discussion
Diagnosing IgA vasculitis (HSP) often relies on clinical evaluation, and while there are diagnostic tests available, they may not always be necessary. When IgA vasculitis presents with a characteristic rash, healthcare professionals can typically make a diagnosis through visual inspection and a routine examination. The diagnosis primarily hinges on the presence of specific symptoms and the distinct rash. To confirm the diagnosis, a skin or kidney biopsy may be conducted.
Treatment for IgA vasculitis typically revolves around maintaining hydration, resting, and administering medications to alleviate joint or abdominal pain. Medical practitioners commonly recommend the use of NonSteroidal Anti-Inflammatory Drugs (NSAIDs) for pain management. NSAIDs encompass a broad category of medicines, including naproxen and ibuprofen.
Privacy
In situations where the disease information had already been made publicly available (as evidenced by prior articles), genuine names of individuals have been utilized. Conversely, in instances where there was no pre-existing public disclosure or at the explicit request of patients for privacy, pseudonyms have been employed. Furthermore, identities have been deliberately obscured, and certain contextual details and diagnoses have been modified to hinder any attempts at identification. It is essential to emphasize that the patients and encounters described in this work are authentic, and their consent for publication was duly obtained. As responsible authors, we earnestly implore all our readers to honor the privacy and confidentiality of these individuals. Additionally, certain scenarios, assessments, and clinical interventions have been altered to safeguard the anonymity of both patients and healthcare providers.
