Gastrointestinal manifestations in Henoch-Schönlein purpura: a review of 261 patients
Article first published online: 2 JAN 2007
Volume 93, Issue 11, pages 1427–1431, November 2004
How to Cite
Chang, W.-L., Yang, Y.-H., Lin, Y.-T. and Chiang, B.-L. (2004), Gastrointestinal manifestations in Henoch-Schönlein purpura: a review of 261 patients. Acta Paediatrica, 93: 1427–1431. doi: 10.1111/j.1651-2227.2004.tb02623.x
- Issue published online: 2 JAN 2007
- Article first published online: 2 JAN 2007
- Received July 7, 2003; revisions received Nov. 18, 2003 and Mar. 9, 2004; accepted Apr. 21, 2004
- Henoch-Schönlein purpura;
- gastrointestinal manifestations
Aim: Henoch-Schönlein purpura is an IgA-mediated autoimmune vasculitis of children. It often presents with symptoms including purpuric rash, abdominal pain, renal involvement or arthritis. Abdominal pain is a frequent symptom in children with HSP and raises the suspicion of intussusception or perforation. We sought to evaluate abdominal pain via stool occult blood and image studies. Methods: A retrospective study of 261 patients diagnosed with Henoch-Schönlein purpura from December 1991 to December 2001 was conducted. Image studies, including abdominal echo, abdominal CT and panendoscopy, were performed for patients who suffered from abdominal pain. Results: Of the 261 patients, 151 (58%) had abdominal pain, and 46 (17.6%) suffered either overt gastrointestinal bleeding or had positive stool occult blood. Seven patients had gross bloody stools. One acute intussusception and one bowel perforation were noted. One patient suffered from hypovolemic shock due to massive gastrointestinal bleeding. When stool occult blood was 3+ or 4+, the incidence of a positive image finding was high.
Conclusion: We found that stool occult blood and image studies may be necessary regarding severe gastrointestinal involvement. Ultrasonography is an important tool when intussusception or bowel perforation is suspected. Monitoring the vital signs is important, especially in patients with massive gastrointestinal bleeding.