Gastrointestinal Biopsy in Henoch-Schönlein Purpura: A Great Diagnostic Contribution

Akkari, I.; Mrabet, S.; Jazia, E. Ben

doi:10.12890/2017_000662

Cited by 2 publications

(4 citation statements)

References 5 publications

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“…Akkari et al have reported IgA deposition despite the absence of lesion at endoscopy previously. [11] One patient who visited hospital for abdominal pain and loose stool underwent EGD and early gastric cancer was incidentally found and histologically confirmed as well-differentiated adenocarcinoma.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic and microscopic findings of gastrointestinal tract in Henoch–Schönlein purpura

et al. 2019

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Asia has the highest incidence of Henoch–Schönlein purpura (HSP). Although 50% to 75% of patients with HSP manifest gastrointestinal (GI) symptoms, endoscopic, and pathologic findings of HSP have been rarely reviewed in Asia. Patients diagnosed with HSP who had undergone endoscopic biopsy from GI tract (GIT) in Soonchunhyang University Seoul Hospital from 2000 to 2018 were evaluated and 25 cases with 44 biopsies from upper GI tract (U-GIT) or lower GI tract (L-GIT) were enrolled. Their clinical and endoscopic findings and histologic findings of endoscopic biopsy were reviewed. Of the 25 patients, 15 were males and 10 were females. There were 6 children and 19 adults. The most common GI symptom was abdominal pain (20/25), followed by loose stool or diarrhea (9/25). Biopsied sites included 19 from U-GIT (9 stomach and 10 duodenum) and 25 from L-GIT (7 terminal ileum, 1 cecum, 4 ascending, 1 transverse, 2 descending, 7 sigmoid, and 3 rectum). Erythema/petechia was the most common endoscopic finding in U-GIT, while erosion/ulceration was the most common one in L-GIT. In U-GIT, extravasted red blood cell (RBC) (14/19) was the most common histologic finding, while leukocytoclastic vasculitis (LCV)/capillarities were identified in 7 specimens, including 5 duodenum samples. In endoscopic investigations of L-GIT, erosion/ulceration (9/14) was predominantly identified. The most common histologic finding was also extravasted RBC (22/25), while LCV/capillarities were noted in 10 specimens, including 5 specimens from terminal ileum. The HSP commonly involves GIT. Histologic findings of our cases were not significantly different from results of previous studies in Western countries. However, endoscopic and pathologic characteristics of HSP have been rarely reviewed in Asia. Herein, we share experience of endoscopic biopsy of GIT in patients with HSP.

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Section: Discussionmentioning

confidence: 99%

Endoscopic and microscopic findings of gastrointestinal tract in Henoch–Schönlein purpura

et al. 2019

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“…Diagnostic criteria include palpable purpura, age onset ≤20 years, acute abdominal pain, and compatible biopsy of an affected organ, with the presence of two or more giving a sensitivity and specificity approximately 90% in separating adult patients with HSP from those with other causes of vasculitis 5 . Biopsy and direct immunofluorescence may contribute and confirm the diagnosis, especially in adult‐patient population, where the clinical suspicion for HSP is low 6 …”

Section: Figurementioning

confidence: 99%

“…5 Biopsy and direct immunofluorescence may contribute and confirm the diagnosis, especially in adultpatient population, where the clinical suspicion for HSP is low. 6 Ciprofloxacin induced vasculitis is a rare adverse event, being reported in the literature only few times, usually as leukocytoclastic F I G U R E 1 Macroscopic findings of purpura on lower extremities vasculitis (LCV) or mononuclear-cell infiltrate. 7 HSP related to ciprofloxacin, is an unpredictable, idiosyncratic drug reaction, probably mediated by immunologic mechanisms, arising from patients' genetic differences, and probably having a strong HLA dependence.…”

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confidence: 99%

“…9 In conclusion, as ciprofloxacin is a common-used antibiotic, clinicians should be aware of the broad spectrum of its adverse events, targeting to patients' safety, while special attention is needed for patients who developed drug-induced vasculitis to a quinolone, due to reports for cross-reactivity between these drugs. 6 A biopsy, if feasible, could establish a reliable diagnosis and physicians' vigilance may ensure an early and effective treatment.…”

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Henoch‐Schönlein purpura associated with ciprofloxacin

Gkoufa

Sakellariou

Katsoulas

et al. 2020

Dermatologic Therapy

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A 84-year-old Caucasian man, with a history of nephrectomy due to urothelial carcinoma and underlying chronic kidney disease with glomerular filtration rate (GFR) 37 mL/min, presented to our Department with a nonpruritic palpable purpuric rash on lower extremities of 5 days duration. During the last 7 days, patient was receiving ciprofloxacin 500 mg twice daily due to a urinary tract infection. On admission, patient's vital signs were normal and physical examination was unremarkable, without abdominal pain, but an erythematous, hemorrhagic rash of lower extremities, with blistering eruptions was observed. Lesions were painless and palpable (Figure 1). Laboratory analysis showed normal white blood cell count (7.3 × 10 3 /μL, neutrophils: 6.7 × 10 3 /μL) and platelets (348 000/μL) with elevated C-reactive protein (19.17 mg/L [upper limit of normal (ULN) 5 mg/L] and mild deterioration of his chronic renal disease (GFR 32 mL/min).Coagulation parameters were within the normal range. Urinalysis was

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Gastrointestinal Biopsy in Henoch-Schönlein Purpura: A Great Diagnostic Contribution

Cited by 2 publications

References 5 publications

Endoscopic and microscopic findings of gastrointestinal tract in Henoch–Schönlein purpura

Endoscopic and microscopic findings of gastrointestinal tract in Henoch–Schönlein purpura

Henoch‐Schönlein purpura associated with ciprofloxacin

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