Korean J Gastrointest Endosc.  2004 Jun;28(6):317-320.

A Case of Henoch-Schonlein Purpura with Small Bowel Hemorrhage Diagnosed by Capsule Endoscopy

Affiliations
  • 1Department of Internal Medicine, Institute for Digestive Research, Soon Chun Hyang University College of Medicine, Seoul, Korea. schidr@hosp.sch.ac.kr

Abstract

A 23 year-old female patient complained of recurrent abdominal cramps and underwent emergency appendectomy in a private clinic. Two weeks later, she complained of lower GI bleeding and was referred to our hospital. On admission, she had abdominal pain and arthralgia but no hematuria. On physical examination, she was hemodynamically stable but was pale. There was no specific finding in laboratory test, except slightly lower level of blood hemoglobin. EGD revealed no specific findings. Colonoscopy showed fresh blood in the colon with small ulcers and erosions in the ileocecal valve but no source of active bleeding. On third admission day, she developed palpable macular rash initially over her lower legs, ankles, wrist joints and later on anterior abdominal wall. Capsule endoscopy revealed several small and large ulcers and erosions in the entire small bowel with blood clots. She was diagnosed clinically as a case of Henoch-Schonlein purpura through her clinical history and skin lesions. She was administered prednisolone 40 mg/day for a period of one week. Her symptoms, G-I bleeding as well as the skin lesions responded well to steroid therapy and she remained asymptomatic afterwards.

Keyword

Henoch-Schonlein purpura; Gastrointestinal bleeding; Capsule endoscopy
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