<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>0872-671X</journal-id>
<journal-title><![CDATA[Medicina Interna]]></journal-title>
<abbrev-journal-title><![CDATA[Medicina Interna]]></abbrev-journal-title>
<issn>0872-671X</issn>
<publisher>
<publisher-name><![CDATA[Sociedade Portuguesa de Medicina Interna]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0872-671X2022000100027</article-id>
<article-id pub-id-type="doi">10.24950/rspmi.2022.01.236</article-id>
<title-group>
<article-title xml:lang="pt"><![CDATA[Púrpura De Henoch-Schonlein na Idade Avançada: Olhar Além da Pele]]></article-title>
<article-title xml:lang="en"><![CDATA[Henoch-Schonlein Purpura in Advanced Age: Looking Beyond the Skin]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Azevedo]]></surname>
<given-names><![CDATA[Sofia Moura de]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Rocha]]></surname>
<given-names><![CDATA[Diana Isabel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Bertão]]></surname>
<given-names><![CDATA[Manuela Vidigal]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ferreira]]></surname>
<given-names><![CDATA[Álvaro]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
<xref ref-type="aff" rid="Aaf"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Centro Hospitalar Universitário do Porto Serviço de Medicina Interna ]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Centro Hospitalar Universitário do Porto Unidade de Imunologia Clínica ]]></institution>
<addr-line><![CDATA[Porto ]]></addr-line>
<country>Portugal</country>
</aff>
<pub-date pub-type="pub">
<day>30</day>
<month>03</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>30</day>
<month>03</month>
<year>2022</year>
</pub-date>
<volume>29</volume>
<numero>1</numero>
<fpage>27</fpage>
<lpage>30</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_arttext&amp;pid=S0872-671X2022000100027&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_abstract&amp;pid=S0872-671X2022000100027&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.pt/scielo.php?script=sci_pdf&amp;pid=S0872-671X2022000100027&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="pt"><p><![CDATA[Resumo A púrpura de Henoch-Schonlein (PHS) é um subtipo de vasculite cutânea de pequenos vasos que se caracteriza tipicamente pela deposição de IgA nas paredes dos vasos o que origina as lesões petequiais/purpúricas palpáveis, sem trombocitopenia, tipicamente nas extremidades inferiores. Clinicamente manifesta-se pela tétrade de púrpura palpável, artrite/artralgias, sintomas gastrointestinais e lesão renal. Infeções, medicações e neoplasia são alguns dos triggers reconhecidos, embora a fisiopatologia ainda não esteja totalmente esclarecida. A morbilidade relaciona-se com evolução para doença renal crónica por glomerulonefrite. A PHS é muito comum nas crianças, mas rara em adultos e idosos. Por este motivo, apresentamos dois casos de PHS em dois doentes com idade superior a 60 anos e com envolvimento renal e intestinal. É importante contemplarmos este diag-nóstico, mesmo - e particularmente - na população adulta pela importante morbimortalidade associada ao envolvimento renal nesta faixa etária, ao contrário do que acontece na população pediátrica.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract Henoch-Schonlein purpura (HSP) is a subtype of small vessel cutaneous vasculitis that is characterized by the deposition of IgA in the vessel walls, which causes palpable petechial/purpuric lesions, non-thrombocytopenic, typically in the lower extremities. Clinically it is manifested by the tetrad: palpable purpura, arthritis/arthralgias, abdominal complaints and kidney injury. Although the pathophysiology is not yet fully understood, infections, medications and neoplasia have been suggested as triggers. Morbidity is related to the progression to chronic kidney disease. PHS is very common in children but rare in adults and the elderly. For this reason, we present two cases of HSP in two patients over 60 years old, with renal and intestinal injury. Because renal involvement and failure is most common in this population (when compared to children), it is important to consider this diagnosis in the adult population due to its important morbidity and mortality.]]></p></abstract>
<kwd-group>
<kwd lng="pt"><![CDATA[Adulto]]></kwd>
<kwd lng="pt"><![CDATA[Idoso]]></kwd>
<kwd lng="pt"><![CDATA[Insuficiência Renal]]></kwd>
<kwd lng="pt"><![CDATA[Vasculite IgA.]]></kwd>
<kwd lng="en"><![CDATA[Adult]]></kwd>
<kwd lng="en"><![CDATA[Aged]]></kwd>
<kwd lng="en"><![CDATA[IgA Vasculitis]]></kwd>
<kwd lng="en"><![CDATA[Renal Insufficiency]]></kwd>
<kwd lng="en"><![CDATA[Renal Insufficiency.]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Daripally]]></surname>
<given-names><![CDATA[VK]]></given-names>
</name>
<name>
<surname><![CDATA[Shah]]></surname>
<given-names><![CDATA[NS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Henoch-Schönlein purpura a rare vasculitis in older adults.J R Coll Physicians]]></article-title>
<source><![CDATA[Edinb]]></source>
<year>2012</year>
<volume>42</volume>
<page-range>124-7</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kushner]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Posnick]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Mones]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Ros]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[An unusual case of Henoch-Schönlein purpura in an elderly male]]></article-title>
<source><![CDATA[J Am Osteopathic Coll Dermatol]]></source>
<year>2014</year>
<volume>30</volume>
<page-range>26-8</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hetland]]></surname>
<given-names><![CDATA[LE]]></given-names>
</name>
<name>
<surname><![CDATA[Susrud]]></surname>
<given-names><![CDATA[KS]]></given-names>
</name>
<name>
<surname><![CDATA[Lindahl]]></surname>
<given-names><![CDATA[KH]]></given-names>
</name>
<name>
<surname><![CDATA[Bygum]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Henoch-Schönlein purpura a literature review]]></article-title>
<source><![CDATA[Acta Derm Venereol]]></source>
<year>2017</year>
<volume>97</volume>
<page-range>1160-6</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Klair]]></surname>
<given-names><![CDATA[JS]]></given-names>
</name>
<name>
<surname><![CDATA[Kaur]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Achanta]]></surname>
<given-names><![CDATA[LM]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A rare cause of rash in elderly diagnostic dilemma]]></article-title>
<source><![CDATA[BMJ Case Rep]]></source>
<year>2014</year>
<volume>2014</volume>
<page-range>bcr2014205601</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Soriano]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Galati]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Vespasiani-Gentilucci]]></surname>
<given-names><![CDATA[U]]></given-names>
</name>
<name>
<surname><![CDATA[Gallo]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[de Vincentis]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Picardi]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Afeltra]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A case of Henoch-Schönlein purpura in the elderly not just a a second childhood]]></article-title>
<source><![CDATA[Aging Clin Exp Res]]></source>
<year>2012</year>
<volume>24</volume>
<page-range>559-60</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chowdhury]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Arafat]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Hussain]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Henoch-Schonlein Purpura in an Elderly Women Presenting with Severe GI Bleeding A case report]]></article-title>
<source><![CDATA[J Bangladesh Coll Phys Surg]]></source>
<year>2010</year>
<volume>26</volume>
<page-range>100-2</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Mak]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Henoch-Schonlein purpura in na elderly lady A case report and literature review]]></article-title>
<person-group person-group-type="editor">
<name>
<surname><![CDATA[Sy]]></surname>
<given-names><![CDATA[Au]]></given-names>
</name>
</person-group>
<source><![CDATA[J Hong Kong Geriatr Soc]]></source>
<year>1999</year>
<volume>9</volume>
<page-range>23-8</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Schaier]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Freitag]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Dikow]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Sommerer]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Gross-Weissmann]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
<name>
<surname><![CDATA[Wal-dherr]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Henoch-Schönlein purpura in adults is not uncommon in elderly patients with an adverse prognosis]]></article-title>
<source><![CDATA[Clin Nephrol]]></source>
<year>2011</year>
<volume>76</volume>
<page-range>49-56</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Rasmussen]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Tisseyre]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Garon-Czmil]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Atzenhoffer]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Guillevin]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Salem]]></surname>
<given-names><![CDATA[JE]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Drug-induced IgA vasculitis in children and adults Revisiting drug causality using a dual pharmacovigilance-based approach]]></article-title>
<source><![CDATA[Autoimmun Rev]]></source>
<year>2021</year>
<volume>20</volume>
<page-range>102707</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lerkvaleekul]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Treepongkaruna]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Saisawat]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Thanachatchairattana]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[An-gkathunyakul]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Ruangwattanapaisarn]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Henoch-Schönlein purpura from vasculitis to intestinal perforation A case report and literature review]]></article-title>
<source><![CDATA[World J Gastroenterol]]></source>
<year>2016</year>
<volume>22</volume>
<page-range>6089-94</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
