We describe a patient who had clinical and anatomopathologic findings that were compatible with Henoch-Schonlein purpura [1] and were associated with intake of acetylsalicylic acid. For 1 week, a 60-year-old man had red spots that were related to mild edema of his legs, ankle arthralgias, and colicky abdominal pain associated with the rectal passage of blood. He had been taking acetylsalicylic acid (500 mg/d) for the past 5 years. After he stopped taking the drug, all signs and symptoms resolved except for mild pain in both ankles. The patient then resumed taking acetylsalicylic acid (this time at a dosage of 900 mg/d). Three days later, the red spots reappeared.

Physical examination showed arterial hypertension (blood pressure, 210/120 mm Hg) and palpable purpura on the lower extremities. No signs of rectal bleeding were detected. Platelet counts and results of tests for coagulation were normal. The blood creatinine level was 128 µmol/L, and the C-reactive protein level was 34 mg/L. Results of tests for antinuclear antibodies, cryoglobulins, C3, and C4 were negative. Urinary protein excretion was 1 g/24 hours, and urinary sediment showed microscopic hematuria. Skin biopsy showed fibrinoid necrosis and inflammatory infiltration accompanied by endothelial tumefaction that was compatible with leukocytoclastic vasculitis. Immunofluorescence studies of the dermal capillaries showed IgA deposits.

To our knowledge, this is the first case of Henoch-Schonlein purpura [1] associated with acetylsalicylic acid and confirmed by the characteristic deposits of IgA in the vascular wall [2]. Although drugs can intervene [3, 4], there is no clear etiologic association with Henoch-Schonlein purpura. However, the fact that the symptoms and signs rapidly resolved after therapy with the drug was stopped and reappeared after use of acetylsalicylic acid resumed allows us to report that the Henoch-Schonlein purpura was a drug-induced reaction [1, 4].