Abstract
Henoch-Schönlein purpura (HSP) belongs to the category of systemic small-vessel vasculitis. Although long-term outcome is generally good, serious complications may occur. Thrombosis and priapism have been reported only as extremely rare complications of HSP. We describe a 37-year-old man who developed recurrent thrombotic events shortly after he had been diagnosed as having HSP. Although he had additional risk factors for thrombosis, such as prothrombin G20210A mutation and use of celecoxib before the last episode, temporal relation of the thrombotic attacks to the onset of HSP suggest that the disease itself may lead to a prothrombotic state. This case is the first adult HSP patient with priapism, which probably developed secondary to thrombosis of the dorsal penile vein.
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References
Rostoker G (2001) Schonlein-henoch purpura in children and adults: diagnosis, pathophysiology and management. BioDrugs 15:99–138
Saulsbury FT (1999) Henoch-Schonlein purpura in children. Report of 100 patients and review of the literature. Medicine (Baltimore) 78:395–409
Saulsbury FT (2001) Henoch-Schonlein purpura. Curr Opin Rheumatol 13:35–40
Michel BA, Hunder GG, Bloch DA, Calabrese LH (1992) Hypersensitivity vasculitis and Henoch-Schonlein purpura: a comparison between the 2 disorders. J Rheumatol 19:721–728
Blanco R, Martinez-Taboada VM, Rodriguez-Valverde V, Garcia-Fuentes M, Gonzalez-Gay MA (1997) Henoch-Schonlein purpura in adulthood and childhood: two different expressions of the same syndrome. Arthritis Rheum 40:859–864
Diana A, Gaze H, Laubscher B, De Meuron G, Tschantz P (2000) A case of pediatric Henoch-Schonlein purpura and thrombosis of spermatic veins. J Pediatr Surg 35:1843
Lind J, Mackay A, Withers SJ (2002) Henoch-Schonlein purpura and priapism. J Paediatr Child Health 38:526–527
Prandota J, Pankow-Prandota L, Kotecki L (2001) Impaired activation of the fibrinolytic system in children with Henoch-Schonlein purpura: beneficial effect of hydrocortisone plus Sigma-aminocaproic acid therapy on disappearance rate of cutaneous vasculitis and fibrinolysis. Am J Ther 8:11–19
Brendel-Muller K, Hahn A, Schneppenheim R, Santer R (2001) Laboratory signs of activated coagulation are common in Henoch-Schonlein purpura. Pediatr Nephrol 16:1084–1088
Monastiri K, Selmi H, Tabarki B, Yacoub M, Mahjoub T, Essoussi AS (2002) Primary antiphospholipid syndrome presenting as complicated Henoch-Schonlein purpura. Arch Dis Child 86:132–133
Garber ME, Mohr BW, Calabrese LH (1993) Henoch-Schonlein purpura associated with anti-Ro (SSA) and antiphospholipid antibody syndrome. J Rheumatol 20:1964–1966
Poort SR, Rosendaal FR, Reitsma PH, Bertina RM (1996) A common genetic variation in the 3’-untranslated region of the prothrombin gene is associated with elevated plasma prothrombin levels and an increase in venous thrombosis. Blood 88:3698–3703
Ozbek N, Atac FB, Verdi H, Kayiran SM (2003) Purpura fulminans in a child with combined heterozygous prothrombin G20210A and factor V Leiden mutations. Ann Hematol 82:118–120
Crofford LJ, Oates JC, McCune WJ, Gupta S, Kaplan MJ, Catella-Lawson F et al. (2000) Thrombosis in patients with connective tissue diseases treated with specific cyclooxygenase 2 inhibitors. A report of four cases. Arthritis Rheum 43:1891–1896
Crofford LJ (2002) Specific cyclooxygenase-2 inhibitors: What have we learned since they came into widespread clinical use? Curr Opin Rheumatol 14:225–230
Cleland LG, James MJ, Stamp LK, Penglis PS (2001) COX-2 inhibition and thrombotic tendency: a need for surveillance. Med J Aust 175:214–217
Iorio A, Guercini F, Pini M (2003) Low-molecular-weight heparin for the long-term treatment of symptomatic venous thromboembolism: meta-analysis of the randomized comparisons with oral anticoagulants. J Thromb Haemost 1:1906–1913
Douketis JD, Foster GA, Crowther MA, Prins MH, Ginsberg JS (2000) Clinical risk factors and timing of recurrent venous thromboembolism during the initial 3 months of anticoagulant therapy. Arch Intern Med 160:3431–3436
Secil M, Arslan D, Goktay AY, Esen AA, Dicle O, Pirnar T (2001) The prediction of papaverine induced priapism by color Doppler sonography. J Urol 165:416–418
Evans DT, Ward OE (1994) Dorsal vein thrombosis of the penis presenting to an STD clinic. Genitourin Med 70:406–409
Schmidt BA, Schwarz T, Schellong SM (2000) Spontaneous thrombosis of the deep dorsal penile vein in a patient with thrombophilia. J Urol 164:1649
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Sari, I., Akar, S., Secil, M. et al. Thrombosis and priapism in a patient with Henoch-Schonlein purpura. Rheumatol Int 25, 472–474 (2005). https://doi.org/10.1007/s00296-004-0532-3
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DOI: https://doi.org/10.1007/s00296-004-0532-3