GI involvement in Henoch-Schönlein purpura

• Published in: Gastrointestinal endoscopy Vol. 56; no. 6; pp. 920 - 923
• Main Authors: Esaki, Motohiro, Matsumoto, Takayuki, Nakamura, Shotaro, Kawasaki, Masumi, Iwai, Keiichiro, Hirakawa, Katsuya, Tarumi, Ken-ichi, Yao, Takashi, Iida, Mitsuo
• Format: Journal Article
• Language: English
• Published: New York, NY Mosby, Inc 01.12.2002; Elsevier
• Subjects: Adult; Biological and medical sciences; Dermatology; Duodenal Diseases - diagnosis; Duodenal Diseases - diagnostic imaging; Duodenal Diseases - pathology; Dyskeratosis; Endoscopy, Gastrointestinal; Female; Gastrointestinal Diseases - diagnosis; Gastrointestinal Diseases - diagnostic imaging; Gastrointestinal Diseases - pathology; Humans; Ileum - diagnostic imaging; Male; Medical sciences; Middle Aged; Purpura, Schoenlein-Henoch - diagnosis; Purpura, Schoenlein-Henoch - diagnostic imaging; Purpura, Schoenlein-Henoch - pathology; Radiography; Human; Edema; Skin disease; Mucosa; Diseases of the osteoarticular system; Cardiovascular disease; Gastroscopy; Vascular disease; Case study; Duodenoscopy; Gastroduodenal; Henoch-Schönlein purpura; Digestive diseases; Capillary vessel disease; Intestinal disease; Complication; Ulcer; Endoscopy; Diagnosis; Gastric disease
• ISSN: 0016-5107; 1097-6779
• DOI: 10.1016/S0016-5107(02)70376-3

Background: The diagnosis of Henoch-Schönlein purpura is difficult, especially when abdominal symptoms precede cutaneous lesions. The aim of this study was to determine the distribution of GI involvement in Henoch-Schönlein purpura. Methods: Endoscopic or radiographic findings throughout the entire GI tract were retrospectively reviewed for 7 patients with Henoch-Schönlein purpura. Histopathologic findings were analyzed and correlated with findings at EGD and colonoscopy. Observations: The duodenum and small intestine were most frequently involved (6 patients, each site). Contrast radiography of the small intestine demonstrated thickened mucosal folds or small barium flecks. Findings at EGD were multiple irregular ulcers, mucosal redness and petechiae in the duodenum. In 4 patients, the second part of the duodenum was predominantly affected. Ulcerating lesions accompanied by hematoma-like protrusions were detected in 4 patients in whom leukocytoclastic vasculitis was proven histopathologically. Conclusions: EGD appears to have the greatest diagnostic utility in patients suspected to have Henoch-Schönlein purpura with GI involvement.