title: Gastrointestinal bleeding in adult patients with Henoch-Schönlein purpura.
abstract: We investigated the clinical and endoscopic features of gastrointestinal lesions in adults with Henoch-Schönlein purpura (HSP) causing gastrointestinal bleeding. The study included 24 adult HSP patients with gastrointestinal hemorrhage who underwent both upper gastrointestinal endoscopy and colonoscopy. The controls were 27 adult HSP patients without gastrointestinal hemorrhage. Patients with gastrointestinal bleeding showed higher frequencies of purpura on the upper extremities and trunk, and of elevated serum C-reactive protein (CRP). The rate of concurrent lesions in both the upper and lower gastrointestinal tracts was 91.7 %. The second portion of duodenum and terminal ileum were most frequently and severely involved. Leukocytoclastic vasculitis was detected in severe lesions and was significantly associated with mucosal ischemic changes. Most lesions (95.7 %) dramatically improved after corticosteroid therapy. This study suggests that both upper and lower gastrointestinal examinations are necessary for proper evaluation of gastrointestinal bleeding in patients with HSP.
authors.affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
authors.forename: Eon Jeong
authors.initials: EJ
authors.lastname: Nam
authors.affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
authors.forename: Gun Woo
authors.initials: GW
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
authors.forename: Jong Wan
authors.initials: JW
authors.lastname: Kang
authors.affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
authors.forename: Churl Hyun
authors.initials: CH
authors.lastname: Im
authors.affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
authors.forename: Seong Woo
authors.initials: SW
authors.lastname: Jeon
authors.affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
authors.forename: Chang-Min
authors.initials: CM
authors.lastname: Cho
authors.affiliation: Department of Pathology, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
authors.forename: Ji Yun
authors.initials: JY
authors.lastname: Jeong
authors.affiliation: Department of Pathology, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Park
authors.affiliation: Department of Radiology, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
authors.forename: Yun Jin
authors.initials: YJ
authors.lastname: Jang
authors.affiliation: Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
authors.forename: Young Mo
authors.initials: YM
authors.lastname: Kang
mesh_terms: D000293:Adolescent; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002097:C-Reactive Protein / Q000378:metabolism; D003108:Colonic Diseases / Q000097:blood / Q000209:etiology* / Q000473:pathology; D003113:Colonoscopy; D004378:Duodenal Diseases / Q000097:blood / Q000209:etiology* / Q000473:pathology; D016099:Endoscopy, Gastrointestinal; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000097:blood / Q000209:etiology* / Q000473:pathology; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D007077:Ileal Diseases / Q000097:blood / Q000209:etiology* / Q000473:pathology; D007413:Intestinal Mucosa / Q000098:blood supply; D007511:Ischemia / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000627:therapeutic use; D012189:Retrospective Studies; D060726:Torso; D034941:Upper Extremity; D055815:Young Adult
chemical_list: D000893:Anti-Inflammatory Agents; D002097:C-Reactive Protein; D011241:Prednisone