title: Masked severe stenosing ureteritis: a rare complication of Henoch-Schönlein purpura.
abstract: Henoch-Schönlein purpura (HSP)-associated stenosing ureteritis represents a rare complication of the disease, typically presenting with severe manifestations. This article reports on a 3.5-year-old boy with HSP and severe nephritis who developed a unilateral stenosing ureteritis with atypical manifestations, resulting in a nonfunctional kidney and consequent nephrectomy. The urinary tract ultrasound was normal in the first week of illness, and the diagnosis was made during follow-up 8 months after onset. The predominance of nephritic manifestations may have masked any signs of ureteritis, leading to the delay in diagnosis. To clarify the clinical spectrum of this complication, an extensive review of the literature was performed. We emphasize the necessity of repeated urinary tract ultrasound both early and later in the course of HSP, especially in cases with renal involvement, so that an early diagnosis of this complication can prevent a potentially serious renal outcome.
authors.affiliation: Department of Pediatrics, University Hospital of Ioannina, Stavros Niarchos Avenue, Ioannina, Greece. eksiomou@yahoo.gr
authors.forename: Ekaterini
authors.initials: E
authors.lastname: Siomou
authors.forename: Anastasios
authors.initials: A
authors.lastname: Serbis
authors.forename: Christos
authors.initials: C
authors.lastname: Salakos
authors.forename: Frederica
authors.initials: F
authors.lastname: Papadopoulou
authors.forename: Constantinos J
authors.initials: CJ
authors.lastname: Stefanidis
authors.forename: Antigoni
authors.initials: A
authors.lastname: Siamopoulou
mesh_terms: D001706:Biopsy; D002675:Child, Preschool; D003937:Diagnosis, Differential; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications* / Q000175:diagnosis; D008297:Male; D009392:Nephrectomy; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D014513:Ureter / Q000000981:diagnostic imaging / Q000473:pathology; D014517:Ureteral Obstruction / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery