Paroxysmal drastic abdominal pain with tardive cutaneous lesions presenting in Henoch-Schönlein purpura

Chen, Xiaoliang; Tian, Hong Qing; Li, Jianzhong; Jiang, Tao; Tang, Hua; Li, Yang; Wu, Bin

doi:10.3748/wjg.v18.i16.1991

Cited by 13 publications

(16 citation statements)

References 13 publications

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“…The rectum (80%) is the most frequently affected segment of the lower gastrointestinal tract. 8 HSP is a clinical diagnosis based on both clinical signs and symptoms, but when the presentation is atypical, tissue biopsy may be helpful. 4 On images produced by computed tomography scanning, bowel involvement is seen as a multifocal, symmetrical, and circumferential wall thickening with a target appearance.…”

Section: Discussionmentioning

confidence: 99%

Small bowel ischemia as an unusual complication of Henoch‐Schönlein purpura in an adult: A case report

Yen

Hsu

et al. 2020

Adv in Digestive Medicine

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Section: Discussionmentioning

confidence: 99%

Small bowel ischemia as an unusual complication of Henoch‐Schönlein purpura in an adult: A case report

Yen

Hsu

et al. 2020

Adv in Digestive Medicine

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“…Symptoms are caused by bowel ischemia and edema, and in very few cases, serious complications such as perforation, infarction or intussusceptions may occur [18,19]. On upper gastrointestinal endoscopy, the most important finding is severe erosive duodenitis (in the second part of the duodenum), characteristic, but not pathognomonic for IgA vasculitis [20]. Other endoscopic findings include erythema, petechiae, ulcers, and ecchymotic lesions seen in the gastric antrum, second portion of the duodenum, ileum, and colon.…”

Section: Discussionmentioning

confidence: 99%

Immunoglobulin A Vasculitis Complicated with Clostridium difficile Infection: a Rare Case Report and Brief Review of the Literature

Cojocariu¹,

Stanciu

Ancuţa

et al. 2016

JGLD

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Immunoglobulin A (IgA) vasculitis, formerly called Henoch-Schönlein purpura, is a leukocytoclastic type of vasculitis affecting small vessels with a deposition of immune IgA complexes, clinically characterized by the classic tetrad of nonthrombocytopenic palpable purpura, arthralgia (or arthritis), and gastrointestinal and renal involvement. Although the cause of the disease remains unknown, immune complexes of IgA and unidentified antigens seem to play a central pathogenic role. The diagnosis is easily established in the presence of purpura, but may be challenging in its absence, especially when colicky abdominal pain precedes the cutaneous lesions. IgA vasculitis is usually a self-limited disease with a benign course and symptomatic treatment is sufficient for most; in severe cases, however, corticosteroids are necessary. We describe the case of a young adult male presenting with severe abdominal pain, vomiting and fever (38.4ºC). Clinical examination, abdominal ultrasound and plain abdominal radiography excluded an acute abdomen. The occurrence of arthralgia involving both knees and erosive duodenitis at endoscopy, 48 hours upon admission, suggested the diagnosis of IgA vasculitis, confirmed on the following day by the presence of typical purpuric rash on the lower extremities. Corticosteroid therapy led to the resolution of all gastrointestinal and joint manifestations as well as to a significant improvement of cutaneous purpura. However, during the 3rd week of corticosteroid treatment, the patient developed watery diarrhea and the clinical suspicion of Clostridium difficile infection (CDI) was confirmed. The treatment with metronidazole led to the resolution of diarrhea.The peculiarity of this case resides in several aspects: the gastrointestinal and joint manifestations preceded purpura, making diagnosis more difficult; CDI is an extremely rare complication of IgA vasculitis, being, in fact, the second case reported in adults in the literature.

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“…Children with severe gastrointestinal pain and/or requiring hospitalization are at greater risk. The most important part of upper gastrointestinal tract is involved in the second part of the duodenum with endoscopic features including diffuse mucosal redness, petechiae, severe erosive duodenitis, hemorrhagic lesion, and ulcers [28] (Figure 2). Purpuric lesions may be seen on an endoscopy, commonly in the descending duodenum, stomach, and colon.…”

Section: Gastrointestinal Manifestationsmentioning

confidence: 99%

Gastrointestinal Manifestations of IgA Vasculitis-Henoch-Schönlein Purpura

Cojocariu¹,

Sîngeap²,

Chiriac³

et al. 2020

Digestive System - Recent Advances

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Immunoglobulin A vasculitis, formerly called Henoch-Schönlein purpura (HSP), is the most common systemic vasculitis in childhood. It is a small-vessel vasculitis mediated by type III hypersensitivity, manifested as rash accompanied by gastrointestinal (GI) symptoms, arthritis, and nephritis. The etiology of this disease (a leukocytoclastic vasculitis) is still uncertain, but immune complexes of IgA and unidentified antigens seem to have a central pathogenic role. Most often the diagnosis is established after the clinical examination; it is easy at first glance when the clinical presentation includes the classic tetrad of rash (nonthrombocytopenic palpable purpura), arthralgia/arthritis, abdominal pain, and renal manifestations but may be difficult when the gastrointestinal manifestations precede the skin purpuric rash. Gastrointestinal involvement is frequently seen and varies from mild symptoms to severe complications; sometimes the gastrointestinal symptoms (colicky abdominal pain, nausea, vomiting, diarrhea, gastrointestinal bleeding) are the first manifestations of the disease. Immunoglobulin A vasculitis is usually a self-limited disease with a benign course, and the treatment is often symptomatic; in severe cases corticosteroids are necessary.

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Paroxysmal drastic abdominal pain with tardive cutaneous lesions presenting in Henoch-Schönlein purpura

Cited by 13 publications

References 13 publications

Small bowel ischemia as an unusual complication of Henoch‐Schönlein purpura in an adult: A case report

Small bowel ischemia as an unusual complication of Henoch‐Schönlein purpura in an adult: A case report

Immunoglobulin A Vasculitis Complicated with Clostridium difficile Infection: a Rare Case Report and Brief Review of the Literature

Gastrointestinal Manifestations of IgA Vasculitis-Henoch-Schönlein Purpura

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