Gastrointestinal involvement in Henoch-Schönlein purpura

Abstract

HSP may present with acute abdomen without typical skin manifestations, and gastroscopy and colonoscopy can be helpful in the early diagnosis of HSP in these patients. Typical endoscopic findings include diffuse mucosal oedema, erythema, petechia or multiple irregular ulcers, especially in the second portion of the duodenum or in the terminal ileum.

GI Bleeding from Colonic Ecchymoses Associated with Cutaneous Ecchymoses over the Lower Extremities from Leukocytoclastic Vasculitis Mediated by IgA Deposition in Henoch–Schönlein Purpura

“…Gastrointestinal bleeding commonly occurs in this syndrome [1]. This work confirms and extends prior studies [1][2][3][4].…”

“…Gastrointestinal bleeding commonly occurs in this syndrome [1]. This work confirms and extends prior studies [1][2][3][4]. It emphasizes that gastrointestinal ecchymoses is a sufficient explanation for gastrointestinal bleeding in Henoch-Schönlein purpura in the absence of gastrointestinal ischemia, illustrates that the colonic lesions closely resemble the cutaneous ecchymotic lesions, and suggests that the colonic and cutaneous ecchymoses share the same pathophysiology of postcapillary venule leakage of erythrocytes due to leukocytoclastic vasculitis mediated by immunoglobulin A.…”

Henoch–Schönlein Purpura in an Adult Mimicking Crohn’s Disease and Pyoderma Gangrenosum

“…The classical purpuric skin rash seen in children tends to necrose in adults, and can be indistinguishable from pyoderma gangrenosum [2]. The gastrointestinal small vessels are affected commonly in HSP (50-75%), because of vasculitis, with abdominal pain and bleeding being the most common presenting symptoms [3,4]. The small intestine is the most frequently involved site in the GI tract because of its tendency to ischemic injury [5].…”

Henoch–Schönlein purpura complicated with severe gastrointestinal bleeding

“…Of note, abdominal symptoms precede purpuric lesions by several days in 12-19 % of patients with HSP [3,4,[9][10][11], posing diagnostic challenges to physicians. Endoscopic evaluations have received attention as being one of the most attractive diagnostic modalities, as this technique allows for direct visualization of the gastrointestinal tract [3,14,15]. Alternatively, or in addition, the use of abdominal CT can also lead to a prompt diagnosis of the disease, and the Fig.…”