Anaphylactoid Purpura With Massive Gastrointestinal Hemorrhage and Glomerulonephritis

Therapeutics Xv.

“…Laparotomy is required for intussusception, which is rare in adults but occurs in about 3% of affected children (Allen et al, 1960;Hanson and Kornreich, 1967;Goldbloom and Drummond, 1968). Allen et al (1960) point out the importance of early operation to avoid irreducible intussusception, and agree with Wolfsohn (1947) that a sudden worsening of the condition of a purpuric patient with severe colicky abdominal pain and vomiting, constipation or the passage of bright red blood and an abdominal lump is an indication for laparotomy.…”

“…White et al (1966) included 7 cases of steroid-resistant Henoch-Schonlein proliferative glomerulonephritis in their series treated with immunosuppressive drugs. Goldbloom and Drummond (1968) and Shearn (1965) reported a persistent decline in renal function with the development of the nephrotic syndrome in their cases, despite full doses of prednisone (60 mg/d). Boon (1968), Bernhardt (1968 and Gary et al (1970) were likewise unable to alter the development of glomeruolnephritis with corticosteroids.…”

“…Other authors have since reported favourable effects of corticosteroids in gastrointestinal haemorrhage. For example, Goldbloom and Drummond (1968) treated a child with massive haemorrhage and shock, requiring 19-3 litre of whole blood, which was finally controlled within 2 d following intravenous methyl prednisolone. Cohen (1957) and Stefanini and Martino (1956) also noted decrease of intestinal bleeding following prednisolone and prednisone.…”

“…Despite the prompt relief of joint pains, localized oedema and some gastrointestinal symptoms by corticosteroids, most authors agree that they have no effect on the duration of the illness, the frequency of recurrences, or the development of renal complications (Goldbloom and Drummond, 1968;Allen et al, 1960;Hardisty, 1968). Skin lesions alone or haematuria in itself are not therefore regarded as indications for corticosteroid therapy.…”

Intestinal ultrasonographic findings in Schönlein-Henoch syndrome

“…It is observed predominantly in children and leads to purpuric rash, oedema, arthralgia and sometimes nephritis. However, massive intestinal bleeding and intussusception have also been reported [1,3,4,10]. However, massive intestinal bleeding and intussusception have also been reported [1,3,4,10].…”