Henoch-Schonlein purpura leads to functional gastrointestinal disorders.
BACKGROUND
Pain predominant functional gastrointestinal disorders such as irritable bowel syndrome may develop as sequelae to acute infectious gastroenteritis. Henoch-Schonlein purpura is a vaculitis that causes an inflammatory insult to the intestinal mucosa.


OBJECTIVE
To assess whether patients with Henoch-Schonlein purpura are more likely to develop functional gastrointestinal disorders in long-term follow-up than controls.


METHODS
Families of children diagnosed with Henoch-Schonlein purpura from 2002 to 2009 were contacted at least 6 months after an acute episode. Parents completed a validated questionnaire to diagnose functional gastrointestinal disorders according to Rome III criteria.


RESULTS
Thirty-eight patients (mean 9.9 years, range 3-22 years, 19 males) and 38 controls (mean 9.5 years, range 1-24 years, 21 males) were recruited. Of the patients, 81% had abdominal pain with Henoch-Schonlein purpura presentation. Initial abdominal pain had resolved in all cases. At the time of study, 60.5% patients and 2.6% controls had abdominal pain. Children in Henoch-Schonlein purpura group were diagnosed with various functional gastrointestinal disorders: Irritable bowel syndrome in 11%, functional abdominal pain syndrome in 8%, and functional abdominal pain in 2.8%. Steroid usage was associated with higher incidence of abdominal pain (87.5%) at the time of the study as compared to no steroid usage (40.9%), p = 0.0065.


CONCLUSIONS
Patients with Henoch-Schonlein purpura are at an increased risk of developing pain predominant functional gastrointestinal disorders. The presence of abdominal pain and use of steroids at presentation of Henoch-Schonlein purpura are associated with higher incidence of pain predominant functional gastrointestinal disorders.
Department of Pediatric Gastroenterology, Children's Memorial Hospital, Northwestern University, 2300 N Children's Plaza, PO Box #57, Chicago, IL 60614, USA. msaps@childrensmemorial.org
Miguel
M
Saps
Gati
G
Dhroove
Ashish
A
Chogle
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology*; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications*; D007223:Infant; D008297:Male; D055815:Young Adult