A 38-year old previously healthy man presented with progressive rash, abdominal pain, arthralgia, and low -grade fever that was persistent for 2 weeks despite treatment with oral prednisolone at a dose 30mg/day. Examination Physical examination showed diffuse abdominal tenderness and palpable purpura distal to the knees (Panel A). WBC: 13,6000 cells/mm 3 (normal range: 3900-9000 cells/mm 3 ), C-reactive protein: 6.5mg/liter (normal value < 3.0). But other laboratory tests including platelet count and urinalysis were normal. CT revealed thickening of the duodenal and jejunal walls.
The duodenal and skin biopsies revealed leukocytoclastic vasculitis with IgA deposition. Upper gastrointestinal endoscopy was performed (Panel B). What is the diagnosis and treatment for this patient? *This case is from Docplexus editorial team for educative purpose only. Source: NEJM Stay connected, the…
