[Schoenlein-Henoch purpura with intestinal involvement].
A 51-year-old male patient admitted to the hospital because of colic-like abdominal pain, paralytic ileus, anal bleeding and microhaematuria with proteinuria, developed an intestinal ischemia with a serum lactate level of 6.3 mmol/l. An occlusion of the large vessels was excluded angiographically. Perfusion disorders were detected both endoscopically and histologically in the upper gastrointestinal tract and in the terminal ileum. When after two days a palpable purpura appeared on the anterior of both feet, a vasculitis type Schoenlein-Henoch was suspected and treated with high doses of steroids, resulting in decreasing symptoms. From the point of admittance, a nephritic urinary sediment had been apparent, and the renal affliction developed into a nephrotic syndrome without notable reduction in the glomerular filtration rate. On the 13th day of treatment the patient-being on a reduced dose of steroids-suffered from a severe relapse; however, this responded favorably to an increase of the dosage. The kidneys required approximately one year for complete recovery. Based on this case, the Schoenlein-Henoch purpura syndrome and its differential diagnosis are presented, particularly with respect to gastrointestinal symptoms and in view of the pertinent literature.
Blöchinger
M
M
1. Medizinische Abteilung, Städtisches Krankenhaus München-Neuperlach.
Schmitt
W
W
Beer
M
M
Seib
H J
HJ
D000005:Abdomen / Q000000981:diagnostic imaging; D003937:Diagnosis, Differential; D016145:Endoscopy, Digestive System; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011860:Radiography, Abdominal; D014463:Ultrasonography
Purpura Schoenlein-Henoch mit intestinaler Beteiligung.