Table 1 |
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Clinical, demographic and laboratory findings of the 3 patients |
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|
Feature |
Case 1 |
Case 2 |
Case 3 |
|
|
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|
Age (years)/Gender |
62/F |
20/M |
66/M |
|
GI involvment |
Hematemesis/abdominal pain |
Severe abdominal pain/vomitting |
Colicky abdominal pain/vomiting. |
|
Skin rash |
Lower limb and abdomen |
Lower limb |
Lower limb |
|
Joints involved |
Joint tenderness |
Arthritis of the knee and ankles |
arthritis of the ankle |
|
Delay between GI involvement and other symptoms |
3 weeks |
4 weeks |
2 weeks |
|
Haemoglobin (g/dL) |
10.3 |
15.6 |
14.7 |
|
Total leucocyte count (/μL) |
13.000 |
10.400 |
12.200 |
|
Platelet count (/μL) |
343.000 |
360.000 |
371.000 |
|
ESR (mm/1st hour) |
45 |
22 |
37 |
|
Urine microscopy |
Microscopc hematuria |
Normal |
Normal |
|
24-hour urinary proteins |
3.3 gr |
Nil |
Nil |
|
Renal function |
Normal |
Normal |
Normal |
|
occult blood stool tests |
positive |
Not done |
negative |
|
Colonoscopy |
colic poliposis with moderate dysplasia on the biopsy. |
Not done |
Not done |
|
CT of the abdomen |
Not done |
Normal |
Not done |
|
Skin biopsy |
Leucocytoclastic vasculitis DIF: Ig A |
Leucocytoclastic vasculitis DIF: Ig A/C3 |
Leucocytoclastic vasculitis DIF: Ig A/C3 |
|
Oesogastroduodenal endoscopy/Biopsy |
Cardial ulcer with stigmata of bleeding and purpuric lesions of the bulb and the duodenum/presence of leucocytoclastic vasculitis with intestinal metaplasia and Hp gastritis |
Antrite congestive with purpuric lesions of the bulb and the duodenum/presence of leucocytoclastic vasculitis with chronic and moderately active Hp antral gastritis |
Purpuric lesions of the bulb and ulcers of the DI and DII portion of the bulb/erosive duodenitis and leucocytoclastic vasculitis 1 |
|
Kidney biopsy |
Extracapillar glomerulonephritis with Ig A depositis in DIF |
Not done |
Not done |
|
treatment |
Methylprednisolone pulse (1 g/day × 3 days) + oral prednisolone associated with cyclophosphamide pulse |
Colchicine® PPI |
Colchicine® PPI |
|
Outcome |
Complete recovery |
Complete recovery |
Complete recovery |
|
|
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ESR: erythrocyte sedimentation rate; HPE: histopathology; DIF: direct immunofluorescence; GI: Gastrointestial ; PPI: proton pump inhibitors; Hp: Helicobacter pylori |
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|
Hamzaoui et al. International Archives of Medicine 2011 4:31 doi:10.1186/1755-7682-4-31 |
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