title: Gallbladder and Pancreas in Henoch-Schönlein Purpura: Review of the Literature.
abstract: OBJECTIVE
  Involvement of the pancreato-biliary system has been occasionally noted in Henoch-Schönlein purpura. Furthermore, cases of this vasculitis syndrome sometimes develop in the context of a viral hepatitis or after hepatitis vaccination.
  
  
  METHODS
  We completed a review of the literature.
  
  
  RESULTS
  Fifty reports published between 1977 and 2015 were retained for the analysis. A pancreato-biliary involvement was recognized in 34 individually well-described patients (♂:♀ = 19:15) with severe abdominal pain: pancreatitis (N = 20), acalculous cholecystitis (N = 11), both pancreatitis and cholecystitis (N = 3). In all of the pancreatitis patients, full recovery occurred (within ≤3 weeks in three-fourths of the patients). Cholecystectomy was performed in 8 cholecystitis patients. Seventeen Henoch-Schönlein patients (♂:♀ = 9:8) were associated with a viral liver disease and 4 (♂:♀ = 1:3) with a hepatitis vaccination. The vasculitis syndrome rapidly remitted in the 7 patients accompanying hepatitis A or E, in 2 patients of hepatitis B, and in the 4 patients preceded by a vaccination. Henoch-Schönlein purpura seemed to be serious in 5 patients with chronic hepatitis B and in 3 with chronic hepatitis C.
  
  
  CONCLUSIONS
  This analysis indicates that pancreato-biliary involvement is unusual in Henoch-Schönlein purpura. This complication deserves consideration in patients with especially severe abdominal pain. Finally, viral hepatitides and hepatitis vaccinations seem to be rare triggers of Henoch-Schönlein purpura.
authors: *Pediatric Department of Southern Switzerland, Bellinzona †Department of Pediatrics, University Children's Hospital, Bern, Switzerland ‡Foundation IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Pediatric Emergency Department, Milan, Italy.
authors: Rossana
authors: R
authors: Helbling
authors: Sebastiano A G
authors: SA
authors: Lava
authors: Giacomo D
authors: GD
authors: Simonetti
authors: Pietro
authors: P
authors: Camozzi
authors: Mario G
authors: MG
authors: Bianchetti
authors: Gregorio P
authors: GP
authors: Milani
mesh_terms: D002763:Cholecystectomy; D002764:Cholecystitis / Q000150:complications; D005260:Female; D005705:Gallbladder Diseases / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications*; D008297:Male; D010182:Pancreatic Diseases / Q000175:diagnosis / Q000209:etiology*