Ileal ulcers in a patient with Henoch‐Schönlein purpura

ADVANCES IN DIGESTIVE MEDICINE - Tập 2 - Trang 145-148 - 2015
Ying-Yu Shih1, Cheng-Chao Liang1, Cheng-Kuan Lin1, Wei-Fan Hsu1, Chien-Sheng Wu2, Chen-Shuan Chung1,3
1Division of Gastroenterology and Hepatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
2Division of Rheumatology, Department of Internal Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan
3Taiwan Association for the Study of Small Intestinal Diseases, Taiwan

Tóm tắt

SummaryHenoch‐Schönlein purpura (HSP) is a systemic vasculitis characterized by a classic tetrad of nonthrombocytopenic palpable purpura, arthritis, gastrointestinal, and renal involvement. The most common gastrointestinal complaint is abdominal pain. The characteristic endoscopic findings are ulcers seen in the second portion of the duodenum. We present the case of a 45‐year‐old man suffering from abdominal pain. Erythematous purpura over bilateral lower extremities and soreness of the joints developed 3 days before abdominal pain. An abdominal computed tomography showed an edematous change of the intestinal wall and the distal part of the ileum. A retrograde single balloon enteroscopy revealed several discrete ulcers and hyperemic mucosa in the distal ileum. The middle, proximal, and terminal ileum and ileocecal valve to the rectum were not affected. Under the impression of HSP, nonsteroidal anti‐inflammatory drugs and prednisolone were administered. We concluded that balloon‐assisted enteroscopy is helpful for differential diagnosis of small bowel lesions in adult patients with HSP.

Tài liệu tham khảo

Piram M., 2013, Epidemiology of immunoglobulin A vasculitis (Henoch‐Schonlein): current state of knowledge, Curr Opin Rheumatol, 25, 171, 10.1097/BOR.0b013e32835d8e2a 10.1155/2010/597648 Ebert E.C., 2008, Gastrointestinal manifestations of Henoch‐Schonlein Purpura, Dig Dis Sci, 53, 2011, 10.1007/s10620-007-0147-0 Hamzaoui A., 2011, Gastrointestinal involvement revealing Henoch Schonlein purpura in adults: report of three cases and review of the literature, Int Arch Med, 4, 31, 10.1186/1755-7682-4-31 Shin J.I., 2007, Indications of capsule endoscopy in Henoch‐Schonlein syndrome with gastrointestinal symptoms, Am J Med, 120, e13, 10.1016/j.amjmed.2006.02.041 Ichikawa R., 2011, Evaluation of small‐intestinal abnormalities in adult patients with Henoch‐Schonlein purpura using video capsule, Endoscopy, 43, E162, 10.1055/s-0030-1256266 Kim E.H., 2012, Late diagnosis of Henoch‐Schonlein purpura following detection of jejunal ischemia on conventional endoscopy, Endoscopy, 44, E393 Skogestad E., 2005, Capsule endoscopy in Henoch‐Schonlein purpura, Endoscopy, 37, 189, 10.1055/s-2004-826188 Karagozian R., 2004, Henoch‐Schonlein purpura presenting with ileal involvement in an adult, Dig Dis Sci, 49, 1722, 10.1023/B:DDAS.0000043392.64347.ea Saulsbury F.T., 2009, Successful treatment of prolonged Henoch‐Schonlein purpura with colchicine, Clin Pediatr, 48, 866, 10.1177/0009922809337532
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ADVANCES IN DIGESTIVE MEDICINE

Tập 2

145-148

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