Die ileozökale Manifestation einer Purpura Schoenlein-Henoch als seltene Differenzialdiagnose zum Morbus Crohn

Abstract

In the case of a 21-year-old patient gastroscopy and coloscopy were performed because of recurrent abdominal pain with diarrhea and vomiting. Colonoscopy showed moderate signs of inflammation of the rectum and aphthoid ulcerations in the terminal ileum. Since the macroscopic and clinical presentation was compatible with Crohn's disease, therapy with sulfasalacine was started. Because histology showed only lymphoid hyperplasia and the patient was asymptomatic at that time, the medication was ceased. Recurrence of abdominal pain and weight loss, proteinuria and a recurrent palpable purpura of the shanks in synopsis with the result of the previous colonoscopy led to a suspected diagnosis of Schoenlein-Henoch purpura with cutaneous, renal and abdominal manifestation which was confirmed by dermal and renal biopsies.

Gastrointestinal Involvement in Pediatric Polyarteritis Nodosa

“…Thus, previous reports exist of vasculitic patients firstly thought to suffer from IBD (26–29). Endoscopic findings (rectal inflammation, ileitis terminalis, apthoid ulcerations) can even lead to a wrong diagnosis (30), as occurred in our first patient (case 1). Concomitance or posterior appearance of symptoms suggestive of other organs' involvement can help in the differential diagnosis.…”