[Value of abdominal-pelvic computed tomography in adult rheumatoid purpura].
OBJECTIVE
Henoch-Schonlein purpura is a rare eventuality in adulthood. Abdominal involvement can worsen the short-term prognosis and justify medical treatment to avoid surgery.


METHODS
Abdominopelvic computed tomography (CT) was performed in six adult patients (four men and two women; age range, 19-74 years) with Henoch-Schonlein purpura before any treatment. Abdominal symptoms were concomitant with the purpuric rash in two cases and followed it in the other cases.


RESULTS
The small bowel was always involved with a parietal thickening, and the target sign was observed in three patients. The lesions were located in the duodenum in two patients, the jejunum in two and the ileum in five. Two segments were involved in one patient and three segments in another patient. A peritoneal effusion was always present. No colonic lesion was discovered on CT. Once the results were known, all patients received steroids with initially intravenous methylprednisolone in five patients at doses ranging from 80 to 1,000 mg/day. On follow-up, none of the patients underwent surgery.


CONCLUSIONS
Abdominopelvic CT scan demonstrated signs suggestive of intestinal vasculitis. An underlying neoplasia or an eventual other cause of abdominal pain were explored and a steroid therapy was then began with a good outcome. Abdominal CT can be helpful in the diagnosis of abdominal involvement in Henoch-Schonlein purpura.
Service de médecine interne, hôpital Gabriel-Montpied, BP 69, 63003 Clermont-Ferrand, France.
H
H
Mahamedi
M
M
André
C
C
Privat
I
I
Delèvaux
M
M
D'Incan
J C
JC
Piette
C
C
Francès
O
O
Aumaître
D015746:Abdominal Pain / Q000209:etiology*; D000208:Acute Disease; D000328:Adult; D000367:Age Factors; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D007421:Intestine, Small / Q000000981:diagnostic imaging*; D008297:Male; D008775:Methylprednisolone / Q000627:therapeutic use; D008875:Middle Aged; D018579:Patient Selection; D011379:Prognosis; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000592:standards*
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone