{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T21:16:04Z","timestamp":1760044564969,"version":"3.44.0"},"reference-count":16,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2018,7,28]]},"abstract":"<jats:p>We report a 66-year-old man with a history of congestive heart failure, atrial fibrillation on warfarin therapy and chronic kidney disease that presented with acute dyspnoea. He had multiple palpable purpuric lesions on his bilateral lower extremities. Laboratory findings supported acute anaemia with no obvious bleeding source, supratherapeutic international normalised ratio and acute on chronic kidney injury. Oesophogastroduodenoscopy and colonoscopy initially suggested ischaemic colitis. The patient\u2019s legs were treated symptomatically with topical steroids. He later developed acute large volume bloody diarrhoea that made him haemodynamically unstable. Punch biopsy of the skin was consistent with leucocytoclastic vasculitis and direct immunofluorescence demonstrated immunoglobulin A and C3 deposits consistent with Henoch-Schonlein purpura. The patient was treated with oral steroids. Bleeding stabilised and rash resolved. Steroids were successfully tapered. The patient was discharged on haemodialysis but ultimately this was able to be discontinued.<\/jats:p>","DOI":"10.1136\/bcr-2018-224816","type":"journal-article","created":{"date-parts":[[2018,8,9]],"date-time":"2018-08-09T10:02:44Z","timestamp":1533808964000},"page":"bcr-2018-224816","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Adult Henolch-Schonlein purpura: multiorgan failure in the setting of a purpuric rash"],"prefix":"10.1136","volume":"2018","author":[{"given":"Luke","family":"Maxfield","sequence":"first","affiliation":[{"name":"Internal Medicine, University of Tennessee at Chattanooga, College of Health Education and Professional Studies, Chattanooga, Tennessee, USA"},{"name":"Dermatology, Sampson Regional Medical Center, Clinton, NC, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aurora","family":"Peck","sequence":"additional","affiliation":[{"name":"College of Medicine, University of Tennessee at Chattanooga, College of Health Education and Professional Studies, Chattanooga, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura Bond","family":"Youngblood","sequence":"additional","affiliation":[{"name":"Internal Medicine, University of Tennessee at Chattanooga, College of Health Education and Professional Studies, Chattanooga, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,8,9]]},"reference":[{"key":"2025082701525517000_2018.aug09_2.bcr-2018-224816.1","doi-asserted-by":"crossref","first-page":"637","DOI":"10.1016\/j.diii.2014.02.014","article-title":"Henoch-Sch\u00f6nlein purpura in adults","volume":"95","author":"Colleter","year":"2014","journal-title":"Diagn Interv Imaging"},{"key":"2025082701525517000_2018.aug09_2.bcr-2018-224816.2","unstructured":"Bolognia J , Jorizzo JL , Rapini RP , et al . Cutaneous vasculitis. In: Dermatology. 1. 3rd edn. St. Louis, MO: Mosby\/Elsevier:385\u2013409."},{"key":"2025082701525517000_2018.aug09_2.bcr-2018-224816.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2014.01.031"},{"key":"2025082701525517000_2018.aug09_2.bcr-2018-224816.4","doi-asserted-by":"publisher","DOI":"10.1016\/S1875-9572(09)60056-5"},{"key":"2025082701525517000_2018.aug09_2.bcr-2018-224816.5","doi-asserted-by":"publisher","DOI":"10.1016\/j.autrev.2012.08.005"},{"key":"2025082701525517000_2018.aug09_2.bcr-2018-224816.6","doi-asserted-by":"crossref","first-page":"1927","DOI":"10.3892\/ol.2013.1274","article-title":"Adult Henoch-Sch\u00f6nlein purpura associated with small cell lung cancer: A case report and review of the literature","volume":"5","author":"Zhang","year":"2013","journal-title":"Oncol Lett"},{"key":"2025082701525517000_2018.aug09_2.bcr-2018-224816.7","first-page":"AB35","article-title":"A retrospective review of 22 cases of cutaneous vasculitis","volume":"5","author":"Chen","year":"2014","journal-title":"J Am Acad Dermatol"},{"key":"2025082701525517000_2018.aug09_2.bcr-2018-224816.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2012.07.004"},{"key":"2025082701525517000_2018.aug09_2.bcr-2018-224816.9","doi-asserted-by":"publisher","DOI":"10.1053\/sarh.2002.33980"},{"key":"2025082701525517000_2018.aug09_2.bcr-2018-224816.10","doi-asserted-by":"publisher","DOI":"10.1097\/01.ASN.0000013883.99976.22"},{"key":"2025082701525517000_2018.aug09_2.bcr-2018-224816.11","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2009.116624"},{"key":"2025082701525517000_2018.aug09_2.bcr-2018-224816.12","first-page":"CD005128","article-title":"Interventions for preventing and treating kidney disease in Henoch-Schonlein Purpura (HSP)","volume":"8","author":"Hahn","year":"2015","journal-title":"Cochrane Database Syst Rev"},{"key":"2025082701525517000_2018.aug09_2.bcr-2018-224816.13","first-page":"41","article-title":"Significance of vasculopathy in IgA nephropathy patients with regard to Oxford classification and immunostaining findings: a single center experience","volume":"2","author":"Nasri","year":"2013","journal-title":"J Renal Inj Prev"},{"key":"2025082701525517000_2018.aug09_2.bcr-2018-224816.14","doi-asserted-by":"publisher","DOI":"10.1111\/j.1523-1755.2004.05407.x"},{"key":"2025082701525517000_2018.aug09_2.bcr-2018-224816.15","doi-asserted-by":"publisher","DOI":"10.1093\/ndt\/gfl044"},{"key":"2025082701525517000_2018.aug09_2.bcr-2018-224816.16","doi-asserted-by":"crossref","first-page":"115","DOI":"10.4172\/2471-9544.100115","article-title":"Drug-induced lupus syndrome","volume":"2","author":"Tetikkurt","year":"2016","journal-title":"J Vasc"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-224816","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T08:53:06Z","timestamp":1756284786000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-224816"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,9]]},"references-count":16,"alternative-id":["10.1136\/bcr-2018-224816"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-224816","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2018,8,9]]}}}