Abstract
A 36-year-old woman at 28 weeks of gestation was referred to our clinic for evaluation of purpura on her lower limbs. A physical examination revealed palpable purpura spots on her buttock and lower extremities. Urinalysis revealed proteinuria and hematuria. A histopathological examination showed numerous extravasated red blood cells and neutrophilic infiltration in the dermis, as well as fibrinoid degeneration in the vascular wall. Direct immunofluorescence technique showed immunoglobulin A deposition in the vascular wall. A diagnosis of Henoch-Schönlein Purpura was made. We decided to initiate treatment with oral corticosteroids, and her symptoms disappeared. At 39 weeks of gestation, she delivered a healthy baby. During pregnancy, it is difficult to choose a treatment because of potential adverse effects in the fetus. According to earlier 24 case reports, Henoch-Schönlein Purpura often causes severe nephritis, and some cases resulted in fetal death. We should, therefore, pay attention to the conditions of both the patient and fetus in the Henoch-Schönlein Purpura cases in pregnant women. If there is a possibility for development of a serious condition in patients with Henoch-Schönlein Purpura, it is important to explain the risk carefully to the patient and perform the appropriate treatment.
