title: Endoscope images of Schönlein-Henoch purpura.
abstract: OBJECTIVE
  Schönlein-Henoch purpura (SHP) is a systemic condition characterized by purpura associated with leukocytoclastic vasculitis. SHP diagnosis is more difficult in infrequent cases where gastrointestinal (GI) symptoms precede purpura. This report examines 11 cases of SHP at our hospital with specific regard to the incidences and details of GI symptoms.
  
  
  METHODS
  The clinical manifestations and endoscopic findings were investigated for their utility in SHP diagnosis.
  
  
  RESULTS
  Among the 11 cases, 3 showed GI symptoms prior to other manifestations. In terms of GI symptoms, abdominal pain was reported in all 11 cases, diarrhea in 4 cases, and bloody stools in 3 cases. Endoscopic findings were seen in the stomach in 7/10 cases, in the small intestine including the duodenum in 10/11 cases, and in the large intestine in 6/10 cases. The frequency of ulcer formation was significantly higher in the small intestine (including the duodenum) than in the stomach. Multiple specific erythematosus lesions were observed in the stomach and large intestine.
  
  
  CONCLUSIONS
  Familiarity with characteristic endoscopic findings and careful observation of all GI findings are essential for diagnosing SHP in cases in which GI tract symptoms precede cutaneous findings.
authors.affiliation: Division of Gastroenterology and Hepatology, Nihon University School of Medicine, Tokyo, Japan. ryuwest@mb.infoweb.ne.jp
authors.forename: Ryu
authors.initials: R
authors.lastname: Nishiyama
authors.forename: Noriko
authors.initials: N
authors.lastname: Nakajima
authors.forename: Akifumi
authors.initials: A
authors.lastname: Ogihara
authors.forename: Souichirou
authors.initials: S
authors.lastname: Oota
authors.forename: Shun
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Yokoyama
authors.forename: Masahiko
authors.initials: M
authors.lastname: Oonishi
authors.forename: Shunpachi
authors.initials: S
authors.lastname: Miyamoto
authors.forename: Yuuichi
authors.initials: Y
authors.lastname: Akai
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Watanabe
authors.forename: Akitake
authors.initials: A
authors.lastname: Uno
authors.forename: Shigeaki
authors.initials: S
authors.lastname: Mizuno
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ootani
authors.forename: Naohide
authors.initials: N
authors.lastname: Tanaka
authors.forename: Mituhiko
authors.initials: M
authors.lastname: Moriyama
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000368:Aged; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications* / Q000175:diagnosis* / Q000473:pathology; D066298:In Vitro Techniques; D007592:Joint Diseases / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010437:Peptic Ulcer / Q000209:etiology*