Henoch Schonlein purpura in pediatric patients with inflammatory bowel disease: A case series

Abstract

Henoch Schonlein purpura (HSP) is a small vessel vasculitis involving IgA immune complex deposition. HSP is characterized by nonthrombocytopenic palpable purpura, arthritis, abdominal pain, and glomerulonephritis. Mean onset of HSP is 6 years, with most cases occurring in children under 10. 1 HSP is often self-limited, generally resolving with supportive treatment in 1-2 months, though patients with renal involvement can have urinary abnormalities for months to years. 2,3 Recurrence of HSP occurs in 33%-35% of patients, generally within four months of the first episode. [1][2][3] Recurrences are typically shorter and milder than the original episode and may be more common in patients with HSP nephritis. 3 Known HSP triggers include infection, medications, and allergic reactions. In children, anti-TNF therapy has recently been published as a potential trigger of HSP. 4 However, there are no widely known associations between HSP and underlying disease. In adults, associations between HSP and liver cirrhosis as well as malignancy have been reported. 5,6 This case series reviews the clinical course of HSP in five patients with IBD.