A Case of Cerebral Vasculitis in Henoch-Schonlein Purpura

ABSTRACT

Henoch-Schonlein purpura(HSP), also known as anaphylactoid purpura, is a vasculitis of small vessels. Skin, gastrointestinal tract, joints, and kidney are usual location of the acute small vascular damage. Neurologic complications are rare during course of HSP. Hypertensive encephalopathy, uremic encephalopathy, metabolic abnormalities, electrolyte abnormalities or cerebral vasculitis are possible causes of the neurological manifestations of HSP. A 6-year-old girl with HSP presented generalized tonic seizure with drowsy mentality. Electroencephalography(EEG) revealed frequently or nearly continuously diffuse high voltage arrhythmic delta activities and polysharp waves on right hemisphere and prominent polysharp waves on right parieto-occipital areas. Brain magnetic resonance imaging(MRI), showed multifocal high signal intensities in right frontoparietal and left parietal areas involving cortex and subcortical white matter on T2 weighted and fluid attenuated inversion recovery(FLAIR) images. These lesions were compatible with manifestations of vasculitis related HSP encephalopathy. She received oral prednisolone and anticonvulsant therapy. Multifocal T2 hyperintensities had been resolved completely 4 month later with clinical improvement.