GI involvement in Henoch-Schönlein purpura

Esaki, Motohiro; Matsumoto, Takayuki; Nakamura, Shotaro; Kawasaki, Mikio; Iwai, Keiichiro; Hirakawa, Kenji; Tarumi, K; Yao, Takashi; Iida, Mitsuo

doi:10.1016/s0016-5107(02)70376-3

Cited by 109 publications

(59 citation statements)

References 14 publications

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“…It has been considered that abdominal involvement, including pain, nausea, vomiting and/or gastrointestinal bleeding, occurs in more than half of patients affected with HSP [3,9]. The small intestine is the most frequently involved part in the gastrointestinal tract, presumably due to its predilection to ischemic injury [3], while the second portion of the duodenum, as well as the stomach, terminal ileum and colon, are often affected [3,[11][12][13][14]. Of note, abdominal symptoms precede purpuric lesions by several days in 12-19 % of patients with HSP [3,4,[9][10][11], posing diagnostic challenges to physicians.…”

Section: Discussionmentioning

confidence: 99%

“…Of note, abdominal symptoms precede purpuric lesions by several days in 12-19 % of patients with HSP [3,4,[9][10][11], posing diagnostic challenges to physicians. Endoscopic evaluations have received attention as being one of the most attractive diagnostic modalities, as this technique allows for direct visualization of the gastrointestinal tract [3,14,15]. Alternatively, or in addition, the use of abdominal CT can also lead to a prompt diagnosis of the disease, and the Fig.…”

Section: Discussionmentioning

confidence: 99%

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Henoch–Schönlein purpura complicated with severe gastrointestinal bleeding

et al. 2014

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Bleeding from the gastrointestinal tract is one of the common determinants of morbidity and mortality in the ordinary clinical setting. The gastrointestinal involvement of Henoch-Schönlein purpura (HSP) has often been described as self-limiting, with no long-term morbidity. In this report, we describe our experience with a male HSP patient who presented with abdominal pain, loss of appetite and deteriorated renal function associated with nephrotic syndrome. Despite the use of aggressive immunomodulatory treatments, including corticosteroids and plasmapheresis, he developed lethal gastrointestinal hemorrhage. We believe that the accumulation of more experience with additional cases similar to ours is mandatory for the establishment of optimal management for HSP patients with severe gastrointestinal manifestations.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Henoch–Schönlein purpura complicated with severe gastrointestinal bleeding

et al. 2014

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“…Churg-Strauss syndrome (40). One possible explanation for these reports is the unmasking of previously unsuspected cases of Churg-Strauss syndrome through the reduction of oral steroid therapy and its replacement with LTRA (40).…”

Section: Discussionmentioning

confidence: 99%

“…One possible explanation for these reports is the unmasking of previously unsuspected cases of Churg-Strauss syndrome through the reduction of oral steroid therapy and its replacement with LTRA (40). Given the possibility that leukotriene antagonists may directly activate Churg-Strauss syndrome, LTRA treatment should be withdrawn in any patient who develops systemic symptoms with hypereosinophilia (40).…”

Section: Discussionmentioning

confidence: 99%

Effects and Zafirlukast on Capsular Contracture: Long-Term Results

Mazzocchi

Dessy

Alfano

et al. 2012

Int J Immunopathol Pharmacol

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Capsular contracture is a distressing complication after breast augmentation for both the patient and surgeon. Although capsular contracture is a multifactorial process, one common denominator in the successful treatment of this complication is believed to be the abatement of inflammation. Leukotriene antagonists have recently emerged as effective prophylactic agents in reactive airway diseases. A prospective study was carried out on 60 female patients (120 prostheses implanted) with mild/severe capsular contracture in at least one breast. The hardness of capsular contracture was assessed by means of the mammary compliance method. Patients received zafirlukast (AccolateTM) for a 6-month period. Mammary compliance was assessed at the start of the study and thereafter monthly, during drug intake and for one year after drug withdrawal. The results show a significant decrease in breast compliance values in the first 6 months, followed by a significant increase one year after the end of drug intake. Indeed, zafirlukast-treated patients displayed a 6.93% reduction in mammary compliance after 1 month, 14.42% after 3 months, 22.05% after 6 months and 22.52% after 7 months (1 month after the withdrawal of the drug). Thereafter, mammary compliance values gradually increased. A 5.47% reduction in mammary compliance was observed 1 year after drug withdrawal. The present study suggests that zafirlukast may be effective in reducing breast capsule distortion in patients with long-standing contracture, though reduced capsular contracture values are strictly related to the duration of drug intake. Capsular contracture is the most common problem and cause of patient dissatisfaction following augmentation mammaplasty and mammary reconstruction with breast implants; the reported rates of this complication range from 0.5 to 59% (1).Every patient who undergoes implantation with an alloplastic implant experiences capsules around the prostheses. Fibrotic tissue promotes compression around the implant, which in tum distorts and deforms the mass, compromising the aesthetic result and causing pain (2-7). Breast firmness that is so marked as to result in a painful, hard breast, on occasion with visible distortion, has been termed fibrous capsular contracture (8). A number of intraoperative and postoperative factors may be linked to capsular contracture. Unfortunately, as few strictly-controlled studies have been conducted to investigate the causes and possible prevention of capsular contracture, there are as yet no definite data on the aetiopathogenesis of this complication (8). Although the pathogenesis of capsular contractere is still unclear, most reports indicate a multifactor explanation (2-6).The development of a fibrotic capsule around

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“…Mukosa berwarna kemerahan, petekia yang berbentuk seperti cincin, dan erosi perdarahan diindikasikan pada kasus hematemesis, melena, dan nyeri epigastrium. 21 Laporan beberapa peneliti dari Taiwan memperlihatkan lesi mukosa terlihat pada 6 dari 9 kasus gastrointestinal. 1 Penemuan yang paling sering adalah duodenitis erosive haemorrhagic.…”

Section: Gambarunclassified

Bula Hemoragik dengan Komplikasi Perforasi Gaster Sebagai Manifestasi Klinis Purpura Henoch-Schonlein yang Tidak Biasa pada Anak

Setiabudiawan

Ghrahani

Sapartini

et al. 2016

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Purpura Henoch-Schonlein (PHS) merupakan vaskulitis pada pembuluh darah kecil tersering terjadi pada anak. Penyakit ini ditandai dengan purpura palpablenontrombositopenia disertai salah satu gejala nyeri perut, artritis atau atralgia, glomerulonefritis, dan hasil biopsi jaringan berupa gambaran vaskulitis leukositoklastik. Bula hemoragik disertai edema jaringan subkutan merupakan gambaran yang tidak umum pada PHS dan sering terlewatkan. Manifestasi klinis vesikobulosa PHS sering ditemukan pada pasien dewasa, 16%–60% kasus, sedangkan pada anak kurang dari 2% kasus. Walaupun PHS secara tipikal merupakan penyakit selflimiting, tetapi komplikasi serius dapat terjadi. Perforasi gaster sangat jarang dilaporkan sebagai komplikasi PHS. Kami melaporkan 2 kasus PHS dengan manifestasi kulit yang berat, yaitu timbulnya bula hemoragik disertai dengan perforasi gaster. Pada kedua kasus dilakukan tindakan operatif dengan keluaran yang berbeda, pada kasus pertama pasien dipulangkan dalam kondisi baik pascaoperasi setelah dilakukan laparatomi eksplorasi, walaupun masih menderita nefritis. Sedangkan pasien kedua meninggal setelah tindakan diagnostic peritoneal lavagedisebabkan sepsis berat. Simpulan, bula hemoragik dapat dipertimbangkan sebagai prediktor komplikasi perforasi gaster pada PHS yang akan meningkatkan kewaspadaan dalam tata laksana PHS

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GI involvement in Henoch-Schönlein purpura

Cited by 109 publications

References 14 publications

Henoch–Schönlein purpura complicated with severe gastrointestinal bleeding

Henoch–Schönlein purpura complicated with severe gastrointestinal bleeding

Effects and Zafirlukast on Capsular Contracture: Long-Term Results

Bula Hemoragik dengan Komplikasi Perforasi Gaster Sebagai Manifestasi Klinis Purpura Henoch-Schonlein yang Tidak Biasa pada Anak

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