Postoperative anaphylactoid purpura complicated with nephrotic syndrome in a patient with esophageal cancer—a case report—

Abstract

Anaphylactoid purpura (AP) is vasculitis with immune complex deposition, which mainly contains IgA antibody. AP mainly develops in children. It has been rarely reported in adults and is sometimes complicated with severe renal disfunction.
A 75-year-old woman developed wound infection with methicillin-resistant sraphylococcus aureus (MRSA) after undergoing surgery for the resolution of postoperative ileus in esophageal cancer ; after 2 days she had abdominal pain and fever. Her condition improved after receiving wound treatment, but she simultaneously developed purpura in bilateral legs. She was diagnosed with AP on the basis of clinical information and immunological and serological data. After bed rest and treatment with hemostatic agents, her AP was resolved. However, subsequently, AP recurred and progressed to purpura nephritis complicated with nephrotic syndrome. Her condition became stable after receiving steroid pulse therapy.
We had some reports of adult AP case as dermadrome, but a few reports of postoperative AP. The cause of AP in our case was wound infection with MRSA, under general condition with the background of malignant disease and operative damage.