Intest Res.  2011 Aug;9(2):148-152. 10.5217/ir.2011.9.2.148.

A Case of Henoch-Schonlein Purpura with Suspicious Focal Bowel Necrosis in an Adult

• Kim SJ
• Park CH
• Kim SY
• Lee IJ
• Park CM
• Cho CB
• Kwon JW
• Park JW
• Huh KR
• Kim KO
• Baek IH
• Yoo KS
• Kim JH
• Park CK

• KMID: 2233122
• DOI: http://doi.org/10.5217/ir.2011.9.2.148

Abstract

Henoch-Schonlein purpura (HSP) is a vasculitis of the small vessels of the skin, joints, gastrointestinal tract, and kidneys characterized by immunoglobulin A deposits in the involved organs. HSP is typified by the classic tetrad of purpura, arthralgia, abdominal pain, and renal involvement. It is common in childhood, but may also occur in adults and can be accompanied by severe complications. Gastrointestinal symptoms occur in up to 85% of patients, and gastrointestinal involvement can manifest as severe problems including intussusception, obstruction, and perforation. The disease course is often self-limited, but severe manifestations occasionally require surgical intervention. We report the case of a 24-year-old man with HSP who presented with abdominal pain and vomiting. Computerized tomography revealed thickening of the ileal wall and multifocal disrupted prominent mucosal enhancement. These findings suggested hemorrhagic enteritis and mucosal necrosis. After treatment with high dose corticosteroids, the lesion improved and surgical intervention was avoided. Our experience suggests that corticosteroid therapy may help in controlling HSP with suspicious small bowel necrosis.

Keyword

Henoch-Schonlein Purpura; Bowel Necrosis; Steroids; Renal Involvement; Leukocytoclastic Vasculitis

MeSH Terms

Abdominal Pain
Adrenal Cortex Hormones
Adult
Arthralgia
Enteritis
Gastrointestinal Tract
Humans
Immunoglobulin A
Intussusception
Joints
Kidney
Necrosis
Purpura
Purpura, Schoenlein-Henoch
Skin
Steroids
Vasculitis
Vasculitis, Leukocytoclastic, Cutaneous
Vomiting
Young Adult
Adrenal Cortex Hormones
Immunoglobulin A
Steroids
Vasculitis, Leukocytoclastic, Cutaneous