Korean J Gastrointest Endosc.  2002 Aug;25(2):92-97.

A Case of Henoch-Sch nlein Purpura with Gastrointestinal Hemorrhage Diagnosed by Renal Biopsy

• Lee HJ
• Kim SW
• Kim JH
• Cheung DY
• Cho BS
• Kwun NK
• Kim SH
• Cho YK
• Lee IS
• Cho MG
• Chung IS

Abstract

Henoch-Sch nlein purpura is a systemic leukoclastic vasculitis with palpable purpura, gastrointestinal manifestations such as abdominal pain and gastrointestinal bleeding and renal problems. It is common in childhood, but can occur during adulthood. Adult have severer symptoms and worse prognosis than children. The pathogenesis of Henoch-Sch nlein purpura is autoimmune vasculitis mediated by immune complex such as IgA1. It is very helpful to find vasculitis and precipitation of immune complex (IgA1, C3) in the skin, gastrointestinal mucosal or renal biopsy for diagnosis. We report a case of Henoch-Sch nlein purpura with hematuria and proteinuria which could be diagnosed by renal needle biopsy due to absence of vasculitis findings in the skin and gastrointestinal mucosal biopsies. In summary, the pattern of evolution of this patient's dermatologic findings, gastrointestinal symptoms, bleeding, hematuria and proteinuria are typical of Henoch-Sch nlein purpura, but the definite diagnosis was very difficult due to absence of much related illness and no vasculitis in the skin and gastrointestinal mucosa. The meaning of renal biopsy in detection and management of Henoch-Sch nlein purpura with he maturia and proteinura was emphasized when vasculitis in the skin and gastrointestinal mucosa was not seen.

Keyword

Henoch-Sch nlein purpura; Gastrointestinal bleeding; Hematuria; Nephritis

MeSH Terms

Abdominal Pain
Adult
Antigen-Antibody Complex
Biopsy*
Biopsy, Needle
Child
Diagnosis
Gastrointestinal Hemorrhage*
Hematuria
Hemorrhage
Humans
Immunoglobulin A
Mucous Membrane
Nephritis
Prognosis
Proteinuria
Purpura*
Skin
Vasculitis
Antigen-Antibody Complex
Immunoglobulin A