Summary
A case of Schönlein-Henoch Purpura (SHP) in a 32 year-old female, showing gastrointestinal manifestations including acute vasculitic cholecystitis was reported. In the course of hospitalization urgent laparotomy was performed because of the severe abdominal pain. The gallbladder was inflamed with a brownish-red edematous wall and subserosal hemorrhage, and was resected. Histological examination of the resected gallbladder specimen revealed leucocytoclastic vasculitis. The patient was treated with prednisolone postoperatively, and symptoms abated over two weeks. Acute cholecystitis with SHP is extremely rare, and as far as the authors know this is the second case of this disorder documented by histological examination. Patients with acute abdomen associated with SHP should be managed with consideration of the complications of acute cholecystitis.
Similar content being viewed by others
References
Feldt RH, Stickler GB: The gastrointestinal manifestations of anaphylactoid purpura in children. Proc Mayo Clin 1962; 29:465–483
Cream JJ, Gumpel JM, Peachey RDG: Schönlein-Henoch Purpura in the adult. A study of77 adults with anaphylactoid or Schönlein-Henoch Purpura. Quart J Med 1970; 39:461–484
Sams WM, Thorne EG, Small P, et al: Leucocytoclastic vasculitis. Arch Dermtol 1976; 112:219–226
Fauci AS, Haynes BF, Katz P: The spectrum of vasculitis. Clinical, pathologic, immunologic, and therapeutic considerations. Ann Intern Med 1978; 89:660–676
Smith HJ, Krupski WC: Spontaneous intestinal perforation in Schönlein-Henoch Purpura. South Med J 1980; 73:603–606
Byrn JR, Fitzgerald JF, Northway JD, et al: Unusual manifestations of Henoch-Schönlein Syndrome. Am J Dis Child 1976; 130:1335–1337
Maltinez-F LA, Haase GM, Ernster JA, et al: Surgical complications in Henoch-Schönlein purpura. J Pediat Surg 1984; 19:434–436
Agha FP, Nostrant TT, Keren DF, et al: Leucocytoclastic vasculitis (hypersensitivity angitis) of the small bowel presenting with severe gastrointestinal hemorrhage. Am J Gastroenterol 1986; 81:195–198
Lopez LR, Schocket AL, Stanford RE, et al: Gastrointestinal involvement in leucocytoclastic vasculitis and polyarteritis nodosa. J Rheumatol 1980; 7:677–684
Scully RE, Galdabini JJ, McNeely BU: Case records of Massachusetts General Hospital (Case 14-1980). N Engl J Med 1980; 302:853–858
Jones NF, Creamer B, Gimlette TMD: Hypoproteinemia in anaphylactoid purpura. Br Med J 1966; 2:1166–1168
Borges WH: Anaphylactoid purpura. Med Clin North Am 1976; 56:201–206
Saulsbury FT: Antinuclear antibody in Henoch-Schönlein purpura. Am J Med Sci 1986; 291:180–182
Beale MG, Nash GS, Bertovich MJ, et al: Similar disturbances in B cell activity and regulatory T cell function in Henoch-Schönlein purpura and systemic lupus erythematosus. J Immunol 1982; 128:486–491
Bannister KM, Drew PA, Clarkson AR, et al: Immunoregulation in glomerulonephritis Henoch-Schönlein Purpura and lupus nephritis. Clin Exp Immunol 1983; 53:384–390
LiVolsi VA, Perzin KH, Porter M: Polyarteritis nodosa of the gallbladder, presenting as acute cholecystitis. Gastroenterology 1973; 65:115–123
Author information
Authors and Affiliations
Additional information
An outline of this case was given at the 42nd Meeting of Chugoku-Shikoku District of the Japanese Society of Gastroenterology, 1984.
Rights and permissions
About this article
Cite this article
Kumon, Y., Hisatake, K., Chikamori, M. et al. A case of vasculitic cholecystitis associated with Schönlein-Henoch Purpura in an adult. Gastroenterol Jpn 23, 68–72 (1988). https://doi.org/10.1007/BF02918859
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF02918859