A Case of IgA-related Enteropathy Complicated with Gastrointestinal Bleeding and Progressive IgA Nephropathy: A Possible Variant Henoch-Schönlein Purpura?
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概要
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Here, we report an adult patient with IgA-related enteropathy complicated with massive intestinal bleeding and acute renal failure, but without skin lesions. Surgical resection of the small intestine and steroid pulse therapy was performed. Histopathology revealed significant deposition of IgA and C3 in the small vessels of the intestine and the kidney mesangium. Although skin purpura was absent, the histopathology and clinical manifestations suggested that the pathophysiology was similar to Henoch-Schönlein purpura (HSP), implying IgA-related enteropathy as a subclass of HSP. Retrospective analysis indicates that terminal ileum lesions may be a poor prognostic indicator.
著者
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MUKAI MAKIO
Division of Surgical Pathology, School of Medicine, Keio University
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Kameyama Kaori
Division Of Diagnostic Pathology Keio University School Of Medicine
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Nakamura Shoko
The Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine
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Hisamatsu Tadakazu
The Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine
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Kikuchi Jun
The Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keio University
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Adachi Masayuki
The Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine
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Yamagishi Yoshiyuki
The Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine
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Imaeda Hiroyuki
The Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University
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Hosoe Naoki
The Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine
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Naganuma Makoto
The Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine
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Ebinuma Hirotoshi
The Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine
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Okamoto Susumu
The Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine
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Kanai Takanori
The Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine
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Ogata Haruhiko
The Center for Diagnostic and Therapeutic Endoscopy, School of Medicine, Keio University
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Hanaoka Hironari
The Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keio University
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Furuya Yoshiaki
The Division of Rheumatology, Department of Internal Medicine, School of Medicine, Keio University
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Kawano Yoshinaga
The Division of Nephrology and Endocrinology, Department of Internal Medicine, School of Medicine, K
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Bokuda Kanako
The Division of Nephrology and Endocrinology, Department of Internal Medicine, School of Medicine, K
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Sasamura Hiroyuki
The Division of Nephrology and Endocrinology, Department of Internal Medicine, School of Medicine, K
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Uchida Hiroshi
The Department of Surgery, School of Medicine, Keio University
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Endo Takashi
The Department of Surgery, School of Medicine, Keio University
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Hashiguchi Akinori
Division of Diagnostic Pathology, School of Medicine, Keio University
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Hibi Toshifumi
The Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine
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Mukai Makio
Division Of Diagnostic Pahology Keio University Hospital
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Kameyama Kaori
Division Of Diagnostic Pathology Keio University Hospital
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Hibi Toshifumi
The Department Of Medicine School Of Medicine Keio University
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Hashiguchi Akinori
Division Of Diagnostic Pathology Keio University Hospital
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Sasamura Hiroyuki
The Department Of Internal Medicine School Of Medicine Keio University
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EBINUMA Hirotoshi
The Department of Internal Medicine, Tokyo Electric Power Company Hospital
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HISAMATSU Tadakazu
The Department of Internal Medicine, Keio University School of Medicine
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Hisamatsu Tadakazu
The Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University
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Naganuma Makoto
The Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University
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Bokuda Kanako
The Division of Nephrology and Endocrinology, Department of Internal Medicine, School of Medicine, Keio University
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Kanai Takanori
The Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University
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Yamagishi Yoshiyuki
The Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University
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Sasamura Hiroyuki
The Division of Nephrology and Endocrinology, Department of Internal Medicine, School of Medicine, Keio University
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Hosoe Naoki
The Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University
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Nakamura Shoko
The Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University
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