Henoch–Schonlein Purpura Leads to Functional Gastrointestinal Disorders
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Pain predominant functional gastrointestinal disorders such as irritable bowel syndrome may develop as sequelae to acute infectious gastroenteritis. Henoch–Schonlein purpura is a vaculitis that causes an inflammatory insult to the intestinal mucosa.
To assess whether patients with Henoch–Schonlein purpura are more likely to develop functional gastrointestinal disorders in long-term follow-up than controls.
Patients and Methods
Families of children diagnosed with Henoch–Schonlein purpura from 2002 to 2009 were contacted at least 6 months after an acute episode. Parents completed a validated questionnaire to diagnose functional gastrointestinal disorders according to Rome III criteria.
Thirty-eight patients (mean 9.9 years, range 3–22 years, 19 males) and 38 controls (mean 9.5 years, range 1–24 years, 21 males) were recruited. Of the patients, 81% had abdominal pain with Henoch–Schonlein purpura presentation. Initial abdominal pain had resolved in all cases. At the time of study, 60.5% patients and 2.6% controls had abdominal pain. Children in Henoch–Schonlein purpura group were diagnosed with various functional gastrointestinal disorders: Irritable bowel syndrome in 11%, functional abdominal pain syndrome in 8%, and functional abdominal pain in 2.8%. Steroid usage was associated with higher incidence of abdominal pain (87.5%) at the time of the study as compared to no steroid usage (40.9%), p = 0.0065.
Patients with Henoch–Schonlein purpura are at an increased risk of developing pain predominant functional gastrointestinal disorders. The presence of abdominal pain and use of steroids at presentation of Henoch–Schonlein purpura are associated with higher incidence of pain predominant functional gastrointestinal disorders.
- Starfield B, Katz H, Gabriel A, et al. Morbidity in childhood—a longitudinal view. N Engl J Med. 1984;310:824–829. CrossRef
- Saps M, Seshadri R, Sztainberg M, Schaffer G, Marshall BM, Di Lorenzo C. A prospective school-based study of abdominal pain and other common somatic complaints in children. J Pediatr. 2008.
- Chitkara DK, Rawat DJ, Talley NJ. The epidemiology of childhood recurrent abdominal pain in Western countries: a systematic review. Am J Gastroenterol. 2005;100:1868–1875. CrossRef
- Crushell E, Rowland M, Doherty M, et al. Importance of parental conceptual model of illness in severe recurrent abdominal pain. Pediatrics. 2003;112:1368–1372. CrossRef
- Drossman DA. Gastrointestinal illness and the biopsychosocial model. J Clin Gastroenterol. 1996;22:252–254. CrossRef
- Gwee KA. Irritable bowel syndrome: psychology, biology, and warfare between false dichotomies. Lancet. 1996;347:1267. CrossRef
- Gwee KA, Leong YL, Graham C, et al. The role of psychological and biological factors in postinfective gut dysfunction. Gut. 1999;44:400–406. CrossRef
- McKendrick MW, Read NW. Irritable bowel syndrome—post salmonella infection. J Infect. 1994;29:1–3. CrossRef
- Neal KR, Hebden J, Spiller R. Prevalence of gastrointestinal symptoms six months after bacterial gastroenteritis and risk factors for development of the irritable bowel syndrome: postal survey of patients. BMJ. 1997;314:779–782.
- Parry SD, Stansfield R, Jelley D, et al. Does bacterial gastroenteritis predispose people to functional gastrointestinal disorders? A prospective, community-based, case-control study. Am J Gastroenterol. 2003;98:1970–1975.
- Parry SD, Stansfield R, Jelley D, et al. Is irritable bowel syndrome more common in patients presenting with bacterial gastroenteritis? A community-based, case-control study. Am J Gastroenterol. 2003;98:327–331. CrossRef
- Rodriguez LA, Ruigomez A. Increased risk of irritable bowel syndrome after bacterial gastroenteritis: cohort study. BMJ. 1999;318:565–566.
- Saps M, Pensabene L, Di Martino L, et al. Post-infectious functional gastrointestinal disorders in children. J Pediatr. 2008;152:812–816. (6 e1). CrossRef
- Gwee KA, Collins SM, Read NW, et al. Increased rectal mucosal expression of interleukin 1β in recently acquired post-infectious irritable bowel syndrome. Gut. 2003;52:523–526. CrossRef
- Spiller RC, Jenkins D, Thornley JP, et al. Increased rectal mucosal enteroendocrine cells, T lymphocytes, and increased gut permeability following acute Campylobacter enteritis and in post-dysenteric irritable bowel syndrome. Gut. 2000;47:804–811. CrossRef
- Collins SM. Is the irritable gut an inflamed gut? Scand J Gastroenterol Suppl. 1992;192:102–105. CrossRef
- Caplan A, Walker L, Rasquin A. Development and preliminary validation of the questionnaire on pediatric gastrointestinal symptoms to assess functional gastrointestinal disorders in children and adolescents. J Pediatr Gastroenterol Nutr. 2005;41:296–304. CrossRef
- Caplan A, Walker L, Rasquin A. Validation of the pediatric Rome II criteria for functional gastrointestinal disorders using the questionnaire on pediatric gastrointestinal symptoms. J Pediatr Gastroenterol Nutr. 2005;41:305–316. CrossRef
- Gonzalez-Gay MA, Llorca J. Controversies on the use of corticosteroid therapy in children with Henoch–Schonlein purpura. Semin Arthritis Rheum. 2005;35:135–137. CrossRef
- Huber AM, King J, McLaine P, Klassen T, Pothos M. A randomized, placebo-controlled trial of prednisone in early Henoch–Schonlein purpura [ISRCTN85109383]. BMC Med. 2004;2:7. CrossRef
- Ronkainen J, Koskimies O, Ala-Houhala M, et al. Early prednisone therapy in Henoch–Schonlein purpura: a randomized, double-blind, placebo-controlled trial. J Pediatr. 2006;149:241–247. CrossRef
- Henoch–Schonlein Purpura Leads to Functional Gastrointestinal Disorders
Digestive Diseases and Sciences
Volume 56, Issue 6 , pp 1789-1793
- Cover Date
- Print ISSN
- Online ISSN
- Springer US
- Additional Links
- Henoch–Schonlein purpura
- Post-infectious functional gastrointestinal disorder
- Pain predominant functional gastrointestinal disorder
- Irritable bowel syndrome
- Functional abdominal pain
- Functional abdominal pain syndrome
- Industry Sectors
- Author Affiliations
- 1. Department of Pediatric Gastroenterology, Hepatology & Nutrition, Gastrointestinal Motility and Functional Bowel Disorders Program, Children’s Memorial Hospital, Northwestern University, 2300 N. Children’s Plaza, PO Box #57, Chicago, IL, 60614, USA