[Henoch-Schönlein purpura developed after radical cystectomy].

We report a case of Henoch-Schönlein purpura that developed after radical cystectomy. The patient was a 70-year-old man who visited our hospital with a chief complaint of asymptomatic macroscopic hematuria and was diagnosed with invasive bladder cancer. After providing one course of gemcitabine and cisplatin therapy as neoadjuvant chemotherapy, radical cystectomy was performed. Due to postoperative formation of an abscess just beneath the rectus abdominis muscle, the patient was administered antibiotic treatment. Purpura developed on postoperative day 23, and was diagnosed as Henoch-Schönlein purpura based on skin biopsy. Symptoms disappeared approximately 3 weeks later, after initiating treatment with diaphenylsulfone and prednisolone.

[Genetic risk factors for ischemic cerebrovascular disease--analysis on fifteen candidate prothrombotic gene polymorphisms in the Japanese population].

Accumulating evidence suggests that several polymorphisms in factors regulating blood coagulation, platelet function, and lipid metabolism are relevant for susceptibility to ischemic cerebrovascular diseases (CVD). The present study analyzed 15 genetic polymorphisms possibly associated with atherosclerosis and thrombosis in a case-control study involving a total of 200 genetically unrelated Japanese patients with ischemic CVD (mean age 58.3 +/- 7.6 y) and 281 age- and gender-matched control subjects (59.0 +/- 4.1 y). Control subjects were randomly selected from unrelated donors with no history of documented CVD or any type of cardiovascular disease with normal resting electrocardiograms. Among the factors genotyped, two factors, platelet glycoprotein (GP) Ib alpha (Thr145Met) and NADPH oxidase p22phox (His72Tyr), were significantly associated with CVD after adjustment for acquired risk factors including hypertension, diabetes mellitus, hyperlipidemia, and smoking. For those with age < 60 y, 10.6% of the CVD patients and 2.9% of the control subjects had both of the two risk genotypes (GPIb alpha 145Met and p22phox 72Tyr, p < 0.05). The mean onset-age of CVD was 58.6 +/- 7.7 y for those having no or only one risk genotype, while 53.3 +/- 5.5 y for those having both of the risk genotypes (p < 0.05). Thus, GPIb alpha 145Met and p22phox 72 Tyr are the genetic factors associated with the risk of ischemic CVD in the Japanese. Carrying both of the two mutations might be associated with developing CVD at a younger age.