Successful treatment of mesenteric vasculitis caused by Henoch-Schönlein purpura with methylprednisolone pulse therapy.
Although mesenteric vasculitis due to Henoch-Schönlein purpura (HSP) is relatively uncommon, it is the most life-threatening manifestation associated with high mortality. We describe a 15-year-old boy with HSP who had massive gastrointestinal bleeding and ileus but delayed onset of the purpuric rash. Abdominal ultrasonography revealed thickening of both small and large intestinal walls, and CT found prominent mesenteric vessels with comb sign and double wall of the bowel. These findings were consistent with mesenteric vasculitis and bowel ischaemia. The ischaemic intestine recovered after methylprednisolone pulse therapy and surgical intervention was avoided. Our report suggests that corticosteroid pulse therapy may help controlling HSP with massive gastrointestinal haemorrhage and ischaemic bowel due to widespread mesenteric vasculitis.
Wang
L
L
Chang Gung Children's Hospital at Kaohsiung, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien 833, Taiwan.
Huang
F-C
FC
Ko
S-F
SF
Cheng
M-T
MT
D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D005076:Exanthema / Q000209:etiology; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D007422:Intestines / Q000098:blood supply*; D007511:Ischemia / Q000209:etiology*; D008297:Male; D008638:Mesenteric Arteries; D008775:Methylprednisolone / Q000008:administration & dosage*; D020551:Pulse Therapy, Drug; D016896:Treatment Outcome; D014657:Vasculitis / Q000188:drug therapy* / Q000209:etiology
D000893:Anti-Inflammatory Agents; D008775:Methylprednisolone