Table 1 Clinical, demographic and laboratory findings of the 3 patients
Feature | Case 1 | Case 2 | Case 3 |
|---|---|---|---|
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 |