A 60-year old man with medical history of dyslipidemia and gout presented with palpable purpura, haemorrhagic vesicles in the lower limbs (Fig. 1), small and large joint polyarthritis and abdominal pain without diarrhea. The cardiorespiratory and abdominal examinations were normal, no fever or oxygen desaturation was observed. Initial blood analysis showed normal values except for leukocytosis of 11.8×103/mm3 with left shift and elevated C-reactive protein (12.73mg/dl). Hemoglobin, platelets, coagulation, liver enzymes, renal function and ions were normal. The initial urine test presented proteinuria of 30mg/dl. Chest X-ray showed a right pleural effusion. Blood cultures were negative and cardiac echocardiogram ruled out endocarditis. Human Immunodeficiency Virus, hepatitis B and C virus, Cytomegalovirus, Treponema pallidum, Varicella Zoster Virus, Erythrovirus B19, Bartonella quintina, Bartonella henselae, Coxiella burnetii, Chlamydophila pneumoniae and Mycoplasma pneumoniae serologies were negative. An autoimmunity study was performed (CH50, C3, CD, ANA, anticardiolipine, anti-β2GPI antibodies, ANCA, RF and cryoglobulins) with negative results. The anatomopathological result of skin biopsy showed a small vase vasculitis with IgA deposits (Fig. 2) that confirmed the suspition of Schönlein-Henoch disease. Due to the deterioration of the renal function, a daily dose of 40mg of prednisone was given, with resolution of the symptoms and analytical alterations.
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