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Gastrointestinal manifestation of Henoch-Schönlein ­purpura ­mimicking acute pancreatitis


Authors: V. Kojecký
Authors‘ workplace: Interní klinika IPVZ, Krajská nemocnice T. Bati, a. s., Zlín
Published in: Gastroent Hepatol 2011; 65(2): 94-97
Category: Clinical and Experimental Gastroenterology: Case Report

Overview

The authors describe a patient who was admitted to hospital for recurrent abdominal pain with mild amylase elevation and skin exanthema. Initially, the disease’s course was assessed as mild acute pancreatitis with allergic skin reaction due to the analgesic administered. Unfortunately, the patient’s complaints continued during hospitalisation and her urine amylase level was elevated, around the upper normal limits, together with leukocytosis. Morphologically, the pancreas was absolutely normal without any pathologies associated with pancreatitis. Neither did further investigation detect any pathology that would explain the condition; only gastroscopy revealed petechiae and oedema of the duodenal folds. 10 days after hospital admission new vasculitic eruptions, mostly on limbs, were observed, which led to the diagnosis of Henoch-Schönlein purpura with predominant gastrointestinal involvement. The particularities of gastrointestinal manifestations of this vasculitis in adult patients are also summarised.

Key words:
pancreatitis – Henoch-Schönlein purpura – vasculitis


Sources

1. Blanco R, Martinez-Taboada VM, ­Rodriguez-Valverde V et al. Henoch-Schönlein purpura in adulthood and childhood: two different expressions of the same syndrome. Arthr Rheum 1997; 40(5): 859–864.

2. Ebert EC. Gastrointestinal manifesta­tions of Henoch-Schönlein Purpura. Dig Dis Sci 2008; 53(8): 2011–2009.

3. Borras-Blasco J, Enriquez R, Amoros F et al. Henoch-Schönlein purpura asso­ciated with clarithromycin. Case report and review of literature. Int J Clin Pharmacol Ther 2003; 41(5): 213–216.

4. Ozen S, Pistorio A, Iusan SM et al. EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis 2010; 69(5): 798–806.

5. Sohagia AB, Gunturu SG, Tong TR et al. Henoch-Schönlein purpura-a case report and review of the literature. Gastroenterol Res Pract Epub 2010 May 23.

6. Pillebout E, Thervet E, Hill G et al. ­Henoch-Schönlein Purpura in adults: outcome and prognostic factors. J Am Soc ­Nephrol 2002; 13(5): 1271–1278.

7. Chen MJ, Wang TE, Chang WH et al. Endo­scopic findings in a patient with ­Henoch-Schönlein purpura. World J Gastro_enterol 2005; 11(15): 2354–2356.

8. Esaki M, Matsumoto T, Nakamura S et al. GI involvement in Henoch-Schönlein purpura. Gastrointest Endosc 2002; 56(6): 920–923.

9. Tai CM, Liou JM, Tsai MC et al. EUS features of duodenal lesions in ­Henoch-Schönlein purpura. Gastrointest Endosc 2005; 62(2): 307.

10. Hoffmann JC, Cremer P, Preiss JC et al. Gallbladder involvement of Henoch-Schönlein purpura mimicking acute acalculous cholecystitis. Digestion 2004; 70(1): 45–48.

11. Viola S, Meyer M, Fabre M et al. Ischemic necrosis of bile ducts complicating Schönlein-Henoch purpura. Gastroenterology 1999;117(1): 211–211.

12. Soyer T, Egritas O, Atmaca E et al. Acute pancreatitis: a rare presenting feature of Henoch Schönlein purpura. J. ­Paediatr Child Health 2008; 44(3): 152–153.

13. Weiss PF, Feinstein JA, Luan X et al. ­Effects of corticosteroid on ­Henoch-Schönlein purpura: a systematic review. Pediatrics, 2007; 120(5): 1079–1087.

Labels
Paediatric gastroenterology Gastroenterology and hepatology Surgery

Article was published in

Gastroenterology and Hepatology

Issue 2

2011 Issue 2

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