An Unusual Complication of Lisinopril: A Report of Iatrogenic Henoch-Schönlein Purpura

Henoch-Schönlein purpura (HSP), also known as IgA vasculitis, is a hypersensitivity vasculitis characterized by palpable purpuric lesions associated with polyarthralgia, abdominal discomfort, and renal involvement. We present the case of a 41-year-old man who was admitted to the emergency department due to generalized purpuric lesions and abdominal pain. During the complementary study, there was no evidence of thrombocytopenia or coagulopathy but confirmed microscopic haematuria. The diagnosis of HSP was supported by the presence of leukocytoclastic vasculitis with perivascular IgA deposits in the skin biopsy. After excluding infectious, autoimmune, and neoplastic pathologies, the possibility of HSP associated with taking lisinopril, which had been recently initiated after hospitalization for acute heart failure, was assumed. Angiotensin-converting enzyme (ACE) inhibitor suspension and treatment with systemic corticosteroids lead to significant clinical regression, supporting our suspicion.