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Henoch–Schönlein purpura following Yersinia enterocolitica infection

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We describe a case of Henoch–Schönlein purpura (HSP) in a 19-year-old woman triggered by a diarrhoeal illness from Yersinia enterocolitica. The patient subsequently developed a widespread purpuric rash on the upper and lower limbs (Box), spasmodic abdominal pain, polyarthralgia and macroscopic haematuria. A skin biopsy confirmed leukocytoclastic vasculitis. Immunofluorescence testing on a percutaneous renal biopsy revealed strong mesangial staining for IgA. While post-infectious proliferative glomerulonephritis with Y. enterocolitica is described in several case series, the syndrome of HSP after this infection has rarely been reported.1,2 This case reinforces that any immune stimulus in IgA-producing tissue, including gastrointestinal infection, can trigger HSP.

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