Henoch-Schönlein purpura in rheumatoid arthritis
Mitsuhashi, H.; Mitsuhashi, M.; Tsukada, Y.; Yano, S.; Naruse, T.
Journal of Rheumatology 21(6): 1138-1140
1994
ISSN/ISBN: 0315-162X PMID: 7932429 Document Number: 423154
This is the first report of Henoch-Schonlein purpura associated with permanent joint damage due to rheumatoid arthritis, which was observed in 3 of the 10 adults we treated for Henoch-Schonlein purpura since 1974. Each of 3 women had been admitted with palpable purpura of the lower extremities. The diagnosis was based on various findings including arthralgia, stiffness, and/or swelling of the joints, and on the results of radiographic, immunofluorescence and other studies. Renal biopsy revealed slight mesangial proliferation in 2 of the patients. The nephropathy did not deteriorate following discharge. However, bilateral swelling of the wrists with destructive joint changes was subsequently observed on radiographs in all patients. Since 2 patients showed positivity for human leukocyte antigen DR4, this antigen may have been a genetic factor in the joint disease in these patients.