Acute pancreatitis as initial manifestation of adult Henoch–Schönlein purpura

Abstract

Abdominal pain observed in Henoch-Schönlein purpura (HSP) is usually attributed to edema and hemorrhage in the small bowel wall, secondary to a small-vessel vasculitis. Pancreatitis secondary to HSP is extremely rare. Here we report a 53-year-old man presented with acute pancreatitis that developed into characteristic rashes seen during HSP at the second day of the clinical onset, together with arthritis and glomerulonephritis. HSP is a rare and benign cause of acute pancreatitis. This complication can occur as an initial manifestation of HSP. Elevated serum amylase level can be considered as the early diagnostic tool for HSP pancreatitis. The patients with HSP who have abdominal pain as their chief complaint should be evaluated for pancreatitis, by routine serum amylase and abdominal computed tomography scan, to plan the specific treatment and avoid unnecessary surgery.

Atypical course of Henoch-Schonlein purpura in an adult patient

“…During the procedure there were revealed inflammatory changes mainly in the small intestine. In the course of the disease the small intestine is most often affected [ 14 ]. The suspicion of Crohn's disease arose.…”

Appropriate Search of the Etiologies of Acute Pancreatitis

“…Vasculitides AP due to vasculitides has been reported in systemic lupus erythematosus [38,39], polyarteritisnodosa [40], Wegener granulomatosis [41], Henoch-Schönleinpurpura [42] and Behcet disease [43]. Diagnosis is usually done by the presence of AP during the setting of these active diseases.…”

Henoch-Schönlein purpura in an adult patient: a clinical case with dramatic presentation

“…Zajęcie nerek dotyczy ok. 30% przypadków HSP u dzieci oraz 60% u dorosłych [12]. Klinicznie choroba przejawia się krwinkomoczem, czasem makroskopowym krwiomoczem, różnego stopnia białkomoczem, a w 20-40% przypadków schyłkową niewydolnością nerek [13].…”