Henoch–Schönlein purpura complicated with severe gastrointestinal bleeding

Yamazaki, Tomoyuki; Akimoto, Tetsu; Iwazu, Yoshitaka; Sugase, Taro; Takeshima, Eri; Numata, Akihiko; Komada, Takanori; Yoshizawa, Hiromichi; Otani, Naoko; Morishita, Yoshiyuki; Saito, Osamu; Muto, Shigeaki; Kusano, Eiji; Nagata, Daisuke

doi:10.1007/s13730-014-0148-8

Cited by 15 publications

(13 citation statements)

References 32 publications

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“…Gastrointestinal symptoms were frequently observed in children with HSP, accounting for 50%~75% [2,3,9], abdominal distention and abdominal pain are the usual clinical manifestations, and the pathological manifestations are erosion, edema and necrosis of gastrointestinal tract mucosa [10]. Typical endoscopic manifestations of HSP include diffuse mucosal edema, erythema and ecchymosis, or multiple irregular ulcers [11,12].…”

Section: Discussionmentioning

confidence: 99%

“…HSP patients whose main clinical manifestation is gastrointestinal symptoms called abdominal type HSP. Intestinal obstruction and intestinal perforation may occur in severe cases [3,4], if not treated or surgery immediately, it will lead to serious consequences and even death. In current, only a few publications about HSP complicated with GP, it was generally recorded as case reports in previous studies [5][6][7].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Characteristics and Risk Factors of Gastrointestinal Perforation in Children with Henoch-Schönlein Purpura

Q¹,

Cao²,

Ren³

et al. 2020

Preprint

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Background: Henoch-Schönlein purpura (HSP) is a common small vessel vasculitis in children. Gastrointestinal perforation (GP) rarely presents as a complication of HSP and was not well characterized. This study aimed to investigate the clinical features, diagnosis and risk factors of GP in children with HSP. Methods: We retrospectively reviewed the clinical data of 10791 children with HSP who attended our hospital between January 2014 and June 2018 and analyzed the treatment and clinical risk factors of 11 children with HSP complication with GP. Results: GP occurred in 11 children with HSP, with an incidence of 0.10%. Among the 11 cases HSP with GP, 1 case was gastric perforation and 10 cases were intestinal perforation. CT indicates perforation but ultrasonography did not indicate perforation in 5 cases of GP patients. The average duration of abdominal pain in HSP with GP was 9.3 days, and 9 cases (81.8%) with a duration of abdominal pain over 7 days. 3 cases of HSP with GP were treated by gastric/intestinal perforation repair and the other 8 cases were treated by enterectomy. The type of purpura, abdominal pain lasting more than 7 days, hematochezia, renal damage, and methylprednisolone dose more than 2mg/kg in GP with HSP patients show statistically significant compared with the control group (P<0.05). Conclusion: The incidence rate of GP in children with HSP was 0.10%. Abdominal (or mixed) HSP, hematochezia, renal damage, abdominal pain lasting more than 7 days, and methylprednisolone dose more than 2mg/kg may increase the risk of GP in children with HSP. CT has a high sensitivity for the diagnosis of GP. Early diagnosis and timely treatment of HSP with GP were very important for good clinical outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Clinical Characteristics and Risk Factors of Gastrointestinal Perforation in Children with Henoch-Schönlein Purpura

Q¹,

Cao²,

Ren³

et al. 2020

Preprint

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“…Most patients recover quickly with supportive care, including adequate hydration and follow-up. 8 Hospitalization should be strongly considered with severe abdominal pain, significant gastrointestinal bleeding, 9 or marked renal insufficiency. Corticosteroids are often used to treat subcutaneous edema and nephritis.…”

Section: Discussionmentioning

confidence: 99%

IgA vasculitis presenting as abdominal pain and rash

Kopparapu

Jarrett

Kraleti

2019

Baylor University Medical Center Proceedings

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A 57-year-old white man presented with acute abdominal pain and rash without any prodromal symptoms. The skin biopsy confirmed immunoglobulin A (IgA) vasculitis with small vessel vasculitis and perivascular IgA, C3, and fibrin deposition. IgA vasculitis is diagnosed most commonly in children and presents in adults in only 10% of cases. Treatment is usually supportive care, and interventions may be required to avoid complications such as nephrotic syndrome or acute gastrointestinal bleeding. Clinicians should be aware of IgA vasculitis as a potential cause for abdominal pain and rash in adult populations.

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“…[6] Rarely, few cases of complicated HSP as intussusceptions, gastrointestinal bleeding and with cardiac involvement have been reported. [18,20,21] …”

Section: Discussionmentioning

confidence: 99%

Henoch-Schonlein Purpura Successfully Treated with Dexamethasone: A Case Report of Six-Year-Old Female

Adhikari

2017

J Med Res Innov

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Henoch-Schonlein Purpura (HSP) is one of the most common causes of small vessel vasculitis in children. A 6-year-old female presented with abdominal pain, swelling, and rashes over both the legs associated with multiple episodes of vomiting for around 10 days. Stool for the occult blood test was positive, but there was an absence of hematuria and albuminuria. The case was diagnosed as HSP and treated with dexamethasone for 10 days. The patient was finally discharged on the resolution of her symptoms. Early diagnosis and treatment favor the better outcome in cases without any renal complications.

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Henoch–Schönlein purpura complicated with severe gastrointestinal bleeding

Cited by 15 publications

References 32 publications

Clinical Characteristics and Risk Factors of Gastrointestinal Perforation in Children with Henoch-Schönlein Purpura

Clinical Characteristics and Risk Factors of Gastrointestinal Perforation in Children with Henoch-Schönlein Purpura

IgA vasculitis presenting as abdominal pain and rash

Henoch-Schonlein Purpura Successfully Treated with Dexamethasone: A Case Report of Six-Year-Old Female

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