Gastrointestinal involvement in Henoch-Schönlein purpura.
OBJECTIVE
To analyse the gastrointestinal manifestation of Henoch-Schonlein purpura (HSP) in adult patients, including clinical and endoscopic features.


METHODS
Patients with a final diagnosis of HSP admitted from January 1995 to January 2006 were included. Their medical records, including clinical presentation, laboratory data, endoscopy and pathology reports, were reviewed retrospectively.


RESULTS
One-hundred-and-fifteen patients were included. Gastrointestinal symptoms occurred in 90 patients (78.2%), with abdominal pain the most common symptom. Fifty-four patients underwent gastroscopy, while 24 underwent colonoscopy. The endoscopic lesions included mucosal erythema, oedema, multiple irregular ulcers and nodular changes. In the upper GI tract, the second portion of the duodenum was the most frequently involved area and is where the most severe lesions occur. In the lower GI tract, the rectum was the most frequently involved area, but the most severe lesions were found in the terminal ileum.


CONCLUSIONS
HSP may present with acute abdomen without typical skin manifestations, and gastroscopy and colonoscopy can be helpful in the early diagnosis of HSP in these patients. Typical endoscopic findings include diffuse mucosal oedema, erythema, petechia or multiple irregular ulcers, especially in the second portion of the duodenum or in the terminal ileum.
Zhang
Yan
Y
Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, China.
Huang
Xinglan
X
D000006:Abdomen, Acute / Q000175:diagnosis / Q000209:etiology; D000328:Adult; D017677:Age Distribution; D001707:Biopsy, Needle; D015331:Cohort Studies; D003113:Colonoscopy / Q000379:methods; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D005773:Gastroscopy / Q000379:methods; D006801:Humans; D011695:IgA Vasculitis / Q000175:diagnosis* / Q000453:epidemiology*; D007150:Immunohistochemistry; D015994:Incidence; D007413:Intestinal Mucosa / Q000473:pathology; D008297:Male; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution