New purpura immunology findings from Saiseikai Central Hospital, Department of Dermatology described
2009 JUL 20 - (NewsRx.com) -- A report, 'MPO-ANCA- and IgA-positive systemic vasculitis: a possibly overlapping syndrome of microscopic polyangiitis and Henoch-Schoenlein purpura,' is newly published data in Journal of Cutaneous Pathology. "Microscopic polyangiitis (MPA) can be distinguished from Henoch-Schoenlein purpura (HSP) based on the presence of renal-pulmonary complications, myeloperoxidase-antineutrophil cytoplasmic antibody (MPO-ANCA) seropositivity and pauci-immune glomerulonephritis; these characteristics of MPA are generally not found in HSP. Here, we present a unique case with MPA and HSP overlapping syndrome," scientists in Tokyo, Japan report. "A 74-year-old man presented with a skin rash accompanied by intracranial bleeding, acute renal failure and pulmonary hemorrhage resulting in a fatal outcome. An autopsy revealed the marked formation of crescentic glomerulonephritis, diffuse pulmonary alveolar hemorrhage and focal cerebral bleeding. Histological features showing both dermal small-vessel vasculitis and cutaneous polyarteritis nodosa-like arteritis suggested MPA rather than HSP, in which the dermal small vessels are exclusively affected. Meanwhile, capillary immunoglobulin (Ig)A deposits in the skin and glomeruli suggested HSP," wrote T. Nagasaka and colleagues, Saiseikai Central Hospital, Department of Dermatology. The researchers concluded: "As MPA and HSP overlapping syndrome characterized by the synergistic effect of MPO-ANCA and the IgA immune complex may result in a fatal outcome, aggressive immunosuppressive therapy should be initiated as early as possible." Nagasaka and colleagues published their study in the Journal of Cutaneous Pathology (MPO-ANCA- and IgA-positive systemic vasculitis: a possibly overlapping syndrome of microscopic polyangiitis and Henoch-Schoenlein purpura. Journal of Cutaneous Pathology, 2009;36(8):871-7). For more information, contact T. Nagasaka, Saiseikai Central Hospital, Dept. of Dermatology, Minato-ku, Tokyo, Japan. Publisher contact information for the Journal of Cutaneous Pathology is: Blackwell Publishing Inc., 350 Main St., Malden, MA 02148, USA. Keywords: Japan, Tokyo, Purpura Immunology, Acute Kidney Failure, Acute Renal Failure, Autopsy, Cutaneous Pathology, Dermatology, Enzyme Research, Glomerulonephritis, Hematology, Hemorrhage, Immunology, Kidney, Myeloperoxidase, Nephrology, Purpura, Renal Failure, Schoenlein-Henoch Purpura, Surgery, Vasculitis. This article was prepared by Gastroenterology Week editors from staff and other reports. Copyright 2009, Gastroenterology Week via NewsRx.com.
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