Skip to main content

Advertisement

SpringerLink
Log in

Gastrointestinal Manifestations of Henoch-Schonlein Purpura

  • Original Paper
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

Abstract

Henoch-Schonlein Purpura (HSP) is the most common systemic vasculitis in childhood. The diagnostic criteria include palpable purpura with at least one other manifestation—abdominal pain, IgA deposition, arthritis or arthralgia, or renal involvement. Immune complex deposits result in necrosis of the wall of small- and medium-sized arteries with infiltration of tissue by neutrophils and deposition of nuclear fragments, a process called leukocytoclastic vasculitis (LCV). It is often associated with infections, medications, or tumors. It may coexist with or mimic Crohn’s disease. Periumbilical and epigastric pain worsens with meals, from bowel angina. Bleeding is usually occult or, less commonly, associated with melena. Intussusception, the most common surgical complication, is usually ileo-ileo or ileo-colic. Perforations, usually ileal, may occur spontaneously or be associated with intussusception. Ultrasound, recommended as the first diagnostic test, and CT scans may show intussusception and asymmetric bowel wall thickening mainly involving the jejunum and ileum. There are a range of endoscopic findings including gastritis, duodenitis, ulceration, and purpura, with the second portion of the duodenum characteristically being involved more than the bulb. Intestinal biopsies show IgA deposition and LCV in the submucosal vessels. Superficial biopsies may show inflammation, ulceration, edema, hemorrhage, and vascular congestion, presumably due to vasculitis-induced mucosal ischemia. The efficacy of corticosteroids in preventing severe complications or relapses is controversial. The majority of patients, however, improve spontaneously.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Ozen S, Ruperto N, Dillon MJ, Bagga A, Barron K, Davin JC, Kawasaki T, Lindsley C, Petty RE, Prieur AM, Ravelli A, Woo P (2006) EULAR/PReS endorsed consensus criteria for the classification of childhood vasculitides. Ann Rheum Dis 65(7):936–941

    PubMed  CAS  Google Scholar 

  2. Mills JA, Michel BA, Bloch DA, Calabrese LH, Hunder GG, Arend WP, Edworthy SM, Fauci AS, Leavitt RY, Lie JT et al (1990) The American college of rheumatology 1990 criteria for the classification of Henoch-Schonlein purpura. Arthr Rheum 33(8):1114–1121

    Article  CAS  Google Scholar 

  3. Hughes FJ, Wolfish NM, McLaine PN (1988) Henoch-Schonlein syndrome and IgA nephropathy: a case report suggesting a common pathogenesis. Pediatr Nephrol 2(4):389–392

    PubMed  CAS  Google Scholar 

  4. Meadow SR, Scott DG (1985) Berger disease: Henoch-Schonlein syndrome without the rash. J Pediatr 106(1):27–32

    PubMed  CAS  Google Scholar 

  5. Kato S, Ozawa K, Ando N, Naganuma H, Iinuma K, Nagura H (2004) Immunoglobulin A enteropathy: a possible variant of Henoch-Schonlein purpura. Dig Dis Sci 49(11–12):1777–1781

    PubMed  CAS  Google Scholar 

  6. Saulsbury FT (2001) Henoch-Schonlein purpura. Curr Op Rheum 13:35–40

    CAS  Google Scholar 

  7. Moja P, Quesnel A, Resseguier V, Lambert C, Freycon F, Berthoux F, Genin C (1998) Is there IgA from gut mucosal origin in the serum of children with Henoch-Schonlein purpura? Clin Immunol Immunopathol 86(3):290–297

    PubMed  CAS  Google Scholar 

  8. Saulsbury FT (1997) Alterations in the O-linked glycosylation of IgA1 in children with Henoch-Schonlein purpura. J Rheumatol 24:2246–2249

    PubMed  CAS  Google Scholar 

  9. Mosquera J, Rodriquez-Iturbe B (1994) Extracellular neuraminidase production of streptococci associated with acute nephritis. Clin Nephrol 21:21–28

    Google Scholar 

  10. Tomana M, Novak J, Julian BA, Matousovic K, Konecny K, Mestecky J (1999) Circulating immune complexes in IgA nephropathy consist of IgA1 with galactose-deficient hinge region and antiglycan antibodies. J Clin Invest 104:73–81

    PubMed  CAS  Google Scholar 

  11. Hiki Y, Kokubo T, Iwase H, Masaki Y, Sano T, Tanaka A, Toma K, Hotta K, Kobayashi Y (1999) Underglycosylation of IgA1 hinge plays a certain role for its glomerular deposition in IgA nephropathy. J Am Soc Nephrol 10:760–769

    PubMed  CAS  Google Scholar 

  12. Nikolova EB, Tomana M, Russell MW (1994) The role of the carbohydrate chains in the complement (C3) fixation by solid-phase bound human IgA. Immunology 82:321–327

    PubMed  CAS  Google Scholar 

  13. Blanco R, Martinez-Taboada VM, Rodriguez-Valverde V, Garcia-Fuentes M, Gonzalez-Gay MA (1997) Henoch-Schonlein purpura in adulthood and childhood: two different expressions of the same syndrome. Arthr Rheum 40(5):859–864

    CAS  Google Scholar 

  14. Chang WL, Yang YH, Lin YT, Chiang BL (2004) Gastrointestinal manifestations in Henoch-Schonlein purpura: a review of 261 patients. Acta Pediatr 93(11):1427–1431

    Google Scholar 

  15. Calvino MC, Llorca J, Garcin-Porrua C, Fernandez-Iglesias JL, Rodriguez-Ledo P, Gonzalez-Gay MA (2001) Henoch-Schonlein purpura in children from northwestern Spain. A 20–year epidemiologic and clinical study. Medicine 80:279–290

    PubMed  CAS  Google Scholar 

  16. Gardner-Medwin JMM, Dolezalova P, Cummins C, Southwood TR (2002) Incidence of Henoch-Schonlein purpura, Kawasaki disease, and rare vasculitides in children of different ethnic origins. Lancet 360:1197–1202

    PubMed  Google Scholar 

  17. Saulsbury FT (1999) Henoch-Schonlein purpura in children. Report of 100 patients and review of the literature. Medicine 78(6):395–409

    PubMed  CAS  Google Scholar 

  18. Trapani S, Micheli A, Grisolia F, Resti M, Chiappini E, Falcini F, De Martino M (2005) Henoch Schonlein purpura in childhood: epidemiological and clinical analysis of 150 cases over a 5-year period and review of literature. Semin Arthr Rheum 35(3):143–153

    Google Scholar 

  19. Farley TA, Gillespi S, Rasoulpour M, Tolentino N, Hadler JL, Hurwitz E (1989) Epidemiology of a cluster of Henoch-Schonlein purpura. Am J Dis Child 143:798–803

    PubMed  CAS  Google Scholar 

  20. Nielsen HE (1988) Epidemiology of Schonlein-Henoch purpura. Acta Paediatr Scand 77(1):125–131

    PubMed  CAS  Google Scholar 

  21. Motoyama O, Iitaka K (2005) Familial cases of Henoch-Schonlein purpura in eight families. Pediatr Int 47(6):612–615

    PubMed  Google Scholar 

  22. Lindenauer SM, Tank ES (1966) Surgical aspects of Henoch-Schonlein’s purpura. Surgery 59(6):982–987

    PubMed  CAS  Google Scholar 

  23. Chao HC, Kong MS, Lin SJ (2000) Hepatobiliary involvement of Henoch-Schonlein purpura in children. Acta Paediatr Taiwan 41(2):63–68

    PubMed  CAS  Google Scholar 

  24. Cioc AM, Sedmak DD, Nuovo GJ, Dawood MR, Smart G, Magro CM (2002) Parvovirus B19 associated adult Henoch Schonlein purpura. J Cutan Pathol 29(10):602–607

    PubMed  Google Scholar 

  25. Ohtsuka T, Yamazaki S (2005) Prevalence of human parvovirus B19 component NS1 gene in patients with Henoch-Schonlein purpura and hypersensitivity vasculitis. Br J Dermatol 152(5):1080–1081

    PubMed  CAS  Google Scholar 

  26. Challine-Lehmann D, Mauberquez S, Pawlotsky J, Rostoker G (1999) Parvovirus B19 and Schonlein-Henoch purpura in adults. Nephron 83(2):172

    PubMed  CAS  Google Scholar 

  27. Heegaard ED, Taaning EB (2002) Parvovirus B19 and parvovirus V9 are not associated with Henoch-Schonlein purpura in children. Pediatr Infect Dis 21:31–34

    Google Scholar 

  28. Sola Alberich R, Jammoul A, Masana L (1997) Henoch-Schonlein purpura associated with acetylsalicylic acid. Ann Int Med 126(8):665

    PubMed  CAS  Google Scholar 

  29. Niedermaier G, Briner V (1997) Henoch-Schonlein syndrome induced by carbidopa/levodopa. Lancet 349(9058):1071–1072

    PubMed  CAS  Google Scholar 

  30. Goldberg EI, Shoji T, Sapadin AN (1999) Henoch-Schonlein purpura induced by clarithromycin. Internat J Dermatol 38(9):706–708

    CAS  Google Scholar 

  31. Zurada JM, Ward KM, Grossman ME (2006) Henoch-Schonlein purpura associated with malignancy in adults. J Am Acad Dermatol 55(5 Suppl):S65–S70

    PubMed  Google Scholar 

  32. Blanco R, Gonzalez-Gay MA, Ibanez D, Alba C, Perez de Llano LA (1997) Henoch-Schonlein purpura as a clinical presentation of small cell lung cancer. Clin Experim Rheumatol 15(5):545–547

    CAS  Google Scholar 

  33. Pertuiset E, Liote F, Launay-Russ E, Kemiche F, Cerf-Payrastre I, Chesneau AM (2000) Adult Henoch-Schonlein purpura associated with malignancy. Semin Arthr Rheum 29(6):360–367

    CAS  Google Scholar 

  34. Apostolopoulos P, Vafiadis-Zouboulis E, Delladetsima I, Charalambopoulos D, Archimandritis A, Katsilambros N (1999) Henoch-Schonlein purpura associated with Campylobacter enterocolitis. J Clin Gastroenterol 29(4):346–347

    PubMed  CAS  Google Scholar 

  35. Roza M, Galbe M, Gonzalez Baschwitz C, Fernandez M, Miguell MA (1983) Henoch-Schoenlein purpura after shigellosis. Clin Nephrol 20(5):269

    PubMed  CAS  Google Scholar 

  36. Youmbissi TJ, Malik TQ, Ajit Kumar S, Rafi A, Al Khursanny AI, Karkar A (2001) Henoch-Schonlein nephritis and salmonella typhi septicaemia. Nephrol Dialysis Transplant 16(5):1081–1082

    CAS  Google Scholar 

  37. Fiocchi O, Stabellini G, Squerzanti R, Stabellini N, Bedani PL, Tataranni G, Storari A, Farinelli R, Cavazzini PL, Farinelli A (1990) Henoch-Schonlein purpura after Salmonella hirschfeldii infection. Nephron 55(3):316–320

    PubMed  CAS  Google Scholar 

  38. Islek I, Kalayci AG, Gok F, Muslu A (2003) Henoch-Schonlein purpura associated with hepatitis A infection. Pediatr Int 45(1):114–116

    PubMed  Google Scholar 

  39. Maggiore G, Martini A, Grifeo S, De Giacomo C, Scotta MS (1984) Hepatitis B virus infection and Schonlein-Henoch purpura. Am J Dis Child 138(7):681–682

    PubMed  CAS  Google Scholar 

  40. Chave T, Neal C, Camp R (2003) Henoch-Schonlein purpura following hepatitis B vaccination. J Dermatol Treatment 14(3):179–181

    CAS  Google Scholar 

  41. Danemann HA, Texter EC Jr (1967) Adult celiac disease and the Henoch-Schonlein syndrome. Am J Dig Dis 12(9):939–946

    PubMed  CAS  Google Scholar 

  42. Demircin G, Oner A, Erdoan O, Bulbul M, Memi L (1998) Henoch Schonlein purpura and amebiasis. Acta Paediatr Jap 40(5):489–491

    CAS  Google Scholar 

  43. Nguyen-Ho P, Jewell LD, Thomson AB (1998) Hemorrhagic intestinal Henoch-Schonlein purpura complicated by cytomegalovirus infection. Can J Gastroenterol 12(1):71–74

    PubMed  CAS  Google Scholar 

  44. Madison DL, Allen E, Deodhar A, Morrison L (2002) Henoch-Schonlein purpura: a possible complication of hepatitis C related liver cirrhosis. Ann Rheum Dis 61(3):281–282

    PubMed  CAS  Google Scholar 

  45. Aggarwal M, Manske CL, Lynch PJ, Paller MS (1992) Henoch-Schonlein vasculitis as a manifestation of IgA-associated disease in cirrhosis. Am J Kidney Dis 20(4):400–402

    PubMed  CAS  Google Scholar 

  46. Patterson CC, Ross P Jr, Pope-Harman AL, Knight DA, Magro CM (2005) Alpha-1 anti-trypsin deficiency and Henoch-Schonlein purpura associated with anti-neutrophil cytoplasmic and anti-endothelial cell antibodies of immunoglobulin-A isotype. J Cutan Pathol 32(4):300–306

    PubMed  Google Scholar 

  47. Boey CC, Ramanujam TM, Looi LM (1997) Clostridium difficile-related necrotizing pseudomembranous enteritis in association with Henoch-Schonlein purpura. J Pediatr Gastroenterol Nutr 24(4):426–429

    PubMed  CAS  Google Scholar 

  48. Hayakawa T, Imaeda H, Nakamura M, Komoto S, Maruta K, Shiozu H, Ogata H, Iwao Y, Ishii H, Hibi T (2005) Association of pseudomembranous colitis with Henoch-Schonlein purpura. J Gastroenterol 40(6):641–645

    PubMed  Google Scholar 

  49. Gershoni-Baruch R, Broza Y, Brik R (2003) Prevalence and significance of mutations in the familial Mediterranean fever gene in Henoch-Schonlein purpura. J Pediatr 143(5):658–661

    PubMed  CAS  Google Scholar 

  50. Reinauer S, Megahed M, Goerz G, Ruzicka T, Borchard F, Susanto F, Reinauer H (1995) Schonlein-Henoch purpura associated with gastric Helicobacter pylori infection. J Am Acad Dermatol 33(5 Pt 2):876–879

    PubMed  CAS  Google Scholar 

  51. Novak J, Szekanecz Z, Sebesi J, Takats A, Demeter P, Bene L, Sipka S, Csiki Z (2003) Elevated levels of anti-Helicobacter pylori antibodies in Henoch-Schonlein purpura. Autoimmunity 36(5):307–311

    PubMed  CAS  Google Scholar 

  52. Kawasaki M, Hizawa K, Aoyagi K, Kuroki F, Nakahara T, Sakamoto K, Iida M, Fujishima M (1997) Ileitis caused by Henoch-Schonlein purpura. An endoscopic view of the terminal ileum. J Clin Gastroenterol 25(1):396–398

    PubMed  CAS  Google Scholar 

  53. Karagozian R, Turbide C, Szilagyi A (2004) Henoch-Schonlein purpura presenting with ileal involvement in an adult. Dig Dis Sci 49(10):1722–1726

    PubMed  Google Scholar 

  54. Saulsbury FT, Hart MH (2000) Crohn’s disease presenting with Henoch-Schonlein purpura. J Pediatr Gastroenterol Nutr 31(2):173–175

    PubMed  CAS  Google Scholar 

  55. Sano H, Izumida M, Shimizu H, Ogawa Y (2002) Risk factors of renal involvement and significant proteinuria in Henoch-Schonlein purpura. Eur J Pediatr 161(4):196–201

    PubMed  CAS  Google Scholar 

  56. Pillebout E, Thervet E, Hill G, Alberti C, Vanhille P, Nochy D (2002) Henoch-Schonlein Purpura in adults: outcome and prognostic factors. J Am Soc Nephrol 13(5):1271–1278

    PubMed  Google Scholar 

  57. Narchi H (2005) Risk of long term renal impairment and duration of follow up recommended for Henoch-Schonlein purpura with normal or minimal urinary findings: a systematic review. Arch Dis Childhood 90(9):916–920

    CAS  Google Scholar 

  58. Saulsbury FT (2007) Clinical update: Henoch-Schonlein purpura. Lancet 369(9566):976–978

    PubMed  Google Scholar 

  59. Katz S, Borst M, Seekri I, Grosfeld JL (1991) Surgical evaluation of Henoch-Schonlein purpura. Experience with 110 children. Arch Surg 126(7):849–853

    PubMed  CAS  Google Scholar 

  60. Schwab J, Benya E, Lin R, Majd K (2005) Contrast enema in children with Henoch-Schonlein purpura. J Pediatr Surg 40:1221–1223

    PubMed  Google Scholar 

  61. Cull DL, Rosario V, Lally KP, Ratner I, Mahour GH (1990) Surgical implications of Henoch-Schonlein purpura. J Pediatr Surg 25(7):741–743

    PubMed  CAS  Google Scholar 

  62. Ebina K, Kato S, Abukawa D, Nakagawa H (1997) Endoscopic hemostasis of bleeding duodenal ulcer in a child with Henoch-Schonlein purpura. J Pediatr 131(6):934–936

    PubMed  CAS  Google Scholar 

  63. Lippl F, Huber W, Werner M, Nekarda H, Berger H, Weigert N (2001) Life-threatening gastrointestinal bleeding due to a jejunal lesion of Henoch-Schonlein purpura. Endoscopy 33(9):811–813

    PubMed  CAS  Google Scholar 

  64. Agha FP, Nostrant TT, Keren DF (1986) Leucocytoclastic vasculitis (hypersensitivity angiitis) of the small bowel presenting with severe gastrointestinal hemorrhage. Am J Gastroenterol 81(3):195–198

    PubMed  CAS  Google Scholar 

  65. Esaki M, Matsumoto T, Nakamura S, Kawasaki M, Iwai K, Hirakawa K et al (2002) GI involvement in Henoch-Schonlein purpura. Gastrointest Endosc 56:920–923

    PubMed  Google Scholar 

  66. Gunasekaran TS, Berman J, Gonzalez M (2000) Duodenojejunitis: is it idiopathic or is it Henoch-Schonlein purpura without the purpura? J Pediatr Gastroenterol Nutr 30(1):22–28

    PubMed  CAS  Google Scholar 

  67. Di Febo G, Gizzi G, Biasco G, Miglioli M (1984) Colonic involvement in adult patients with Henoch-Schoenlein purpura. Endoscopy 16(1):36–39

    Article  PubMed  CAS  Google Scholar 

  68. Cappell MS, Gupta AM (1990) Colonic lesions associated with Henoch-Schonlein purpura. Am J Gastroenterol 85(9):1186–1188

    PubMed  CAS  Google Scholar 

  69. Chen MJ, Wang TE, Chang WH, Tsai SJ, Liao WS (2005) Endoscopic findings in a patient with Henoch-Schonlein purpura. World J Gastroenterol 11(15):2354–2356

    PubMed  Google Scholar 

  70. Tomomasa T, Hsu JY, Itoh K, Kuroume T (1987) Endoscopic findings in pediatric patients with Henoch-Schonlein purpura and gastrointestinal symptoms. J Pediatr Gastroenterol Nutr 6(5):725–729

    Article  PubMed  CAS  Google Scholar 

  71. van Wieringen PM, van der Zee CL, Hoevenaars F, Joosten HJ, Rieu PN (1992) Esophageal stricture as a complication in Henoch-Schonlein purpura. Eur J Pediatr Surg 2(4):236–238

    PubMed  Google Scholar 

  72. Carmichael P, Brun E, Jayawardene S, Abdulkadir A, O’Donnell PJ (2002) A fatal case of bowel and cardiac involvement in Henoch-Schonlein purpura. Nephrol Dial Transplant 17(3):497–499

    PubMed  Google Scholar 

  73. Deguchi M, Shiraki K, Itoh N, Konishi T, Takase K, Nakano T (2001) Esophageal involvement in adult-onset Schonlein-Henoch purpura. Gastrointest Endosc 53(2):241–244

    PubMed  CAS  Google Scholar 

  74. Choong CK, Kimble RM, Pease P, Beasley SW (1998) Colo-colic intussusception in Henoch-Schonlein purpura. Pediatr Surg Int 14(3):173–174

    PubMed  CAS  Google Scholar 

  75. Sonmez K, Turkyilmaz Z, Demirogullari B, Karabulut R, Aral YZ, Konu O, Baaklar AC, Kale N (2002) Conservative treatment for small intestinal intussusception associated with Henoch-Schonlein’s purpura. Surg Today 32(12):1031–1034

    PubMed  Google Scholar 

  76. Wu CS, Tung SY (1994) Henoch-Schonlein purpura complicated by upper gastrointestinal bleeding with an unusual endoscopic picture. J Clin Gastroenterol 19(2):128–131

    PubMed  CAS  Google Scholar 

  77. Yavuz H, Arslan A (2001) Henoch-Schonlein purpura-related intestinal perforation: a steroid complication? Pediatr Int 43(4):423–425

    PubMed  CAS  Google Scholar 

  78. Smith HJ, Krupski WC (1980) Spontaneous intestinal perforation in Schonlein-Henoch purpura. South Med J 73(5):603–606, 610

    Google Scholar 

  79. Chung DJ, Park YS, Huh KC, Kim JH (2006) Radiologic findings of gastrointestinal complications in an adult patient with Henoch-Schonlein purpura. Am J Roentgenol 187:396–398

    Google Scholar 

  80. Lombard KA, Shah PC, Thrasher TV, Grill BB (1986) Ileal stricture as a late complication of Henoch-Schonlein purpura. Pediatrics 77:396–398

    PubMed  CAS  Google Scholar 

  81. Kawasaki M, Suekane H, Imagawa E, Iida M, Hizawa K, Aoyagi K, Fujishima M (1997) Duodenal obstruction due to Henoch-Schonlein purpura. Am J Roentgenol 168(4):969–970

    CAS  Google Scholar 

  82. Lipsett J, Byard RW (1995) Small bowel stricture due to vascular compromise: a late complication of Henoch-Schonlein purpura. Pediatr Pathol Lab Med 15(2):333–340

    PubMed  CAS  Google Scholar 

  83. Reif S, Jain A, Santiago J, Rossi T (1991) Protein losing enteropathy as a manifestation of Henoch-Schonlein purpura. Acta Pediatr Scand 80(4):482–485

    CAS  Google Scholar 

  84. Wang L, Huang FC, Ko SF, Cheng MT (2003) Successful treatment of mesenteric vasculitis caused by Henoch-Schonlein purpura with methylprednisolone pulse therapy. Clin Rheumatol 22(2):140–142

    PubMed  CAS  Google Scholar 

  85. Roy S (1972) Steatorrhea in Henoch’s syndrome. Br Med J 3:5828

    Google Scholar 

  86. Mohammed R (1982) Acute appendicitis: a complication of Henoch–Schönlein purpura. J R Coll Surg Edinburgh 27:367

    CAS  Google Scholar 

  87. Gow KW, Murphy JJ 3rd, Blair GK, Magee JF, Hailey J (1996) Multiple entero-entero fistulae: an unusual complication of Henoch-Schonlein purpura. J Pediatr Surg 31(6):809–811

    PubMed  CAS  Google Scholar 

  88. Lawes D, Wood J (2002) Acute abdomen in Henoch-Schonlein purpura. J R Soc Med 95(10):505–506

    PubMed  CAS  Google Scholar 

  89. Nistala K, Hyer W, Halligan S (2003) Jejunal haemorrhage in Henoch-Schonlein syndrome. Arch Dis Childhood 88(5):434

    CAS  Google Scholar 

  90. Henriksson P, Hedner U. Nilsson IM (1977) Factor XIII (fibrin stabilising factor) in Henoch-Schonlein’s purpura. Acta Pediatr Scand 66(3):273–277

    CAS  Google Scholar 

  91. De Mattia D, Penza R, Giordano P, Del Vecchio GC, Aceto G, Altomare M, Schettini F (1995) von Willebrand factor and factor XIII in children with Henoch-Schonlein purpura. Pediatr Nephrol 9(5):603–605

    PubMed  Google Scholar 

  92. Dalens B, Travade P, Labbe A, Bezou MJ (1983) Diagnostic and prognostic value of fibrin stabilising factor in Schonlein-Henoch syndrome. Arch Dis Childhood 58(1):12–14

    CAS  Google Scholar 

  93. Kamitsuji H, Tani K, Yasui M, Taniguchi A, Taira K, Tsukada S, Iida Y, Kanki H, Fukui H (1987) Activity of blood coagulation factor XIII as a prognostic indicator in patients with Henoch-Schonlein purpura. Efficacy of factor XIII substitution. Eur J Pediatr 146(5):519–523

    PubMed  CAS  Google Scholar 

  94. Fukui H, Kamitsuji H, Nagao T, Yamada K, Akatsuka J, Inagaki M, Shike S, Kobayashi Y, Yoshioka K, Maki S et al (1989) Clinical evaluation of a pasteurized factor XIII concentrate administration in Henoch-Schonlein purpura. Japanese Pediatric Group. Thromb Res 56(6):667–675

    PubMed  CAS  Google Scholar 

  95. Kumon Y, Hisatake K, Chikamori M, Hara H, Numata Y, Yamano T, Ohno F (1988) A case of vasculitic cholecystitis associated with Schonlein-Henoch purpura in an adult. Gastroenterol Jap 23(1):68–72

    CAS  Google Scholar 

  96. Hoffmann JC, Cremer P, Preiss JC, Ebhardt H, Kruschewski M, Buhr HJ, Zeitz M (2004) Gallbladder involvement of Henoch-Schonlein purpura mimicking acute acalculous cholecystitis. Digestion 70(1):45–48

    PubMed  Google Scholar 

  97. Pery M, Alon U, Lachter JH, Kaftori JK, Gaitini D, Rosenberger A (1990) The value of ultrasound in Schoenlein-Henoch purpura. Eur J Pediatr 150(2):92–94

    PubMed  CAS  Google Scholar 

  98. McCrindle BW, Wood RA, Nussbaum AR (1988) Henoch-Schonlein syndrome. Unusual manifestations with hydrops of the gallbladder. Clin Pediatr 27(5):254–256

    CAS  Google Scholar 

  99. Archimandritis A, Kalos A, Pantzos A, Sakellariou D, Malamas N, Fertakis A (1994) Hemorrhagic ascites in a patient with anaphylactoid purpura. J Clin Gastroenterol 18(3):257–258

    PubMed  CAS  Google Scholar 

  100. Santiago J, Blanco R, Gonzalez-Gay MA, Mateos A, Roses L, Andrade AS, Gonzalez-Vela C (1996) Henoch-Schonlein purpura with hemorrhagic ascites and intestinal serositis. Gastrointest Endosc 44(5):624–625

    PubMed  CAS  Google Scholar 

  101. Lee TH, Lee EY, Cho YS, Yoo B, Moon HB, Lee CK (2003) Concurrent occurrence of chylothorax and chylous ascites in a patient with Henoch-Schonlein purpura. Scand J Rheumatol 32(6):378–379

    PubMed  CAS  Google Scholar 

  102. Viola S, Meyer M, Fabre M, Tounian P, Goddon R, Dechelotte P, Valayer J, Gruner M, Bernard O (1999) Ischemic necrosis of bile ducts complicating Schonlein-Henoch purpura. Gastroenterology 117(1):211–214

    PubMed  CAS  Google Scholar 

  103. Connolly B, O’Halpin D (1994) Sonographic evaluation of the abdomen in Henoch-Schonlein purpura. Clin Radiol 49(5):320–323

    PubMed  CAS  Google Scholar 

  104. Ozdemir H, Iik S, Buyan N, Hasanolu E (1995) Sonographic demonstration of intestinal involvement in Henoch-Schonlein syndrome. Eur J Radiol 20(1):32–34

    PubMed  CAS  Google Scholar 

  105. Couture A, Veyrac C, Baud C, Galifer RB, Armelin I (1992) Evaluation of abdominal pain in Henoch-Schonlein syndrome by high frequency ultrasound. Pediatr Radiol 22(1):12–17

    PubMed  CAS  Google Scholar 

  106. Shirahama M, Umeno Y, Tomimasu R, Dohmen K, Miyamoto Y, Shimoda Y, Irie K, Ishibashi H (1998) The value of colour Doppler ultrasonography for small bowel involvement of adult Henoch-Schonlein purpura. Br J Radiol 71:788–791

    PubMed  CAS  Google Scholar 

  107. Doyle T, Mullany J (1986) The radiological features of Henoch-Schonlein purpura in the gastrointestinal tract. Aust Radiol 30(4):313–316

    CAS  Google Scholar 

  108. Jeong YK, Ha HK, Yoon CH, Gong G, Kim PN, Lee MG, Min YI, Auh YH (1997) Gastrointestinal involvement in Henoch-Schonlein syndrome: CT findings. Am J Roentgenol 168(4):965–968

    CAS  Google Scholar 

  109. Siskind BN, Burrell MI, Pun H. Russo R Jr, Levin W (1985) CT demonstration of gastrointestinal involvement in Henoch-Schonlein syndrome. Gastrointest Radiol 10(4):352–354

    PubMed  CAS  Google Scholar 

  110. Stancanelli B, Vita A, Vinci M, Magnano A, Purrello F (2006) Bleeding of small bowel in Henoch-Schonlein syndrome: the successful diagnostic role of video capsule endoscopy. Am J Med 119(1):82–84

    PubMed  Google Scholar 

  111. Preud’Homme DL, Michail S, Hodges C, Milliken T, Mezoff AG (2006) Use of wireless capsule endoscopy in the management of severe Henoch-Schonlein purpura. Pediatrics 118(3):e904–e906

    PubMed  Google Scholar 

  112. Taylor AC, Allen RM, Buttigieg RJ (2000) Jejunal ulceration and push enteroscopy. Lancet 356(9248):2192–2193

    PubMed  CAS  Google Scholar 

  113. Tai CM, Liou JM, Tsai MC, Wang HP (2005) EUS features of duodenal lesions in Henoch-Schonlein purpura. Gastrointest Endosc 62(2):307; discussion 307

    PubMed  Google Scholar 

  114. Stevenson JA, Leong LA, Cohen AH, Border WA (1982) Henoch-Schonlein purpura: simultaneous demonstration of IgA deposits in involved skin, intestine, and kidney. Arch Pathol Lab Med 106(4):192–195

    PubMed  CAS  Google Scholar 

  115. Kato S, Ebina K, Naganuma H, Sato S, Maisawa S, Nakagawa H (1996) Intestinal IgA deposition in Henoch-Schonlein purpura with severe gastro-intestinal manifestations. Eur J Pediatr 155(2):91–95

    PubMed  CAS  Google Scholar 

  116. Morichau-Beauchant M, Touchard G, Maire P, Briaud M, Babin P, Alcalay D, Matuchansky C (1982) Jejunal IgA and C3 deposition in adult Henoch-Schonlein purpura with severe intestinal manifestations. Gastroenterology 82(6):1438–1442

    PubMed  CAS  Google Scholar 

  117. Kato S, Shibuya H, Naganuma H, Nakagawa H (1992) Gastrointestinal endoscopy in Henoch-Schonlein purpura. Eur J Pediatr 151(7):482–484

    PubMed  CAS  Google Scholar 

  118. Narin N, Akcoral A, Aslin MI, Elmastas H (1995) Ranitidine administration in Henoch-Schonlein vasculitis. Acta Pediatr Jap 37(1):37–39

    CAS  Google Scholar 

  119. Gonzalez-Gay MA, Llorca J (2005) Controversies on the use of corticosteroid therapy in children with Henoch-Schonlein purpura. Semin Arthr Rheum 35(3):135–137

    Google Scholar 

  120. Ronkainen J, Koskimies O, Ala-Houhala M, Antikainen M, Merenmies J, Rajantie J, Ormala T, Turtinen J, Nuutinen M (2006) Early prednisone therapy in Henoch-Schonlein purpura: a randomized, double-blind, placebo-controlled trial. J Pediatr 149(2):241–247

    PubMed  CAS  Google Scholar 

  121. Huber AM, King J, McLaine P, Klassen T, Pothos M (2004) A randomized, placebo-controlled trial of prednisone in early Henoch Schonlein Purpura BMC. Medicine 2:7

    PubMed  Google Scholar 

  122. Mollica F, Li Volti S, Garozzo R, Russo G (1992) Effectiveness of early prednisone treatment in preventing the development of nephropathy in anaphylactoid purpura. Eur J Pediatr 151(2):140–144

    PubMed  CAS  Google Scholar 

  123. Glasier CM, Siegel MJ, McAlister WH, Shackelford GD (1981) Henoch-Schonlein syndrome in children: gastrointestinal manifestations. Am J Roentgenol 136(6):1081–1085

    CAS  Google Scholar 

  124. Rosenblum ND, Winter HS (1987) Steroid effects on the course of abdominal pain in children with Henoch-Schonlein purpura. Pediatrics 79(6):1018–1021

    PubMed  CAS  Google Scholar 

  125. Kaku Y, Nohara K, Honda S (1998) Renal involvement in Henoch-Schonlein purpura: a multivariate analysis of prognostic factors. Kidney Int 53(6):1755–1759

    PubMed  CAS  Google Scholar 

  126. Shin JI, Park JM, Shin YH, Hwang DH, Kim JH, Lee JS (2006) Predictive factors for nephritis, relapse, and significant proteinuria in childhood Henoch-Schonlein purpura. Scand J Rheumatol 35(1):56–60

    PubMed  CAS  Google Scholar 

  127. Rigante D, Candelli M, Federico G, Bartolozzi F, Porri MG (2005) Stabile A. Predictive factors of renal involvement or relapsing disease in children with Henoch-Schonlein purpura. Rheumatol Int 25(1):45–48

    PubMed  Google Scholar 

  128. Hung SH, Yang YH, Lee CC, Wang LC, Lin YT, Chiang BL (2006) Clinical predictors of self-limited urinalysis abnormality in childhood Henoch-Schonlein purpura nephritis. Acta Pediatr 95(3):306–311

    Google Scholar 

  129. Shin JI, Park JM, Shin YH, Kim JH, Kim PK, Lee JS, Jeong HJ (2005) Cyclosporin A therapy for severe Henoch-Schonlein nephritis with nephrotic syndrome. Pediatr Nephrol 20(8):1093–1097

    PubMed  Google Scholar 

  130. Tarshish P, Bernstein J, Edelmann CM Jr (2004) Henoch-Schonlein purpura nephritis: course of disease and efficacy of cyclophosphamide. Pediatr Nephrol 19(1):51–56

    PubMed  Google Scholar 

  131. Rech J, Fuchs F, Kallert S, Hueber AJ, Requadt C, Manger B, Kalden JR, Amann K, Strauss R, Schulze-Koops H (2007) Plasmapheresis therapy in an elderly patient with rapidly progressive Henoch-Schonlein purpura with disseminated organ involvement. Clin Rheumatol 26(1):112–114

    PubMed  CAS  Google Scholar 

  132. Lamireau T, Rebouissoux L, Hehunstre J-P (2001) Intravenous immunoglobulin therapy for severe digestive manifestations of Henoch-Schonlein purpura. Acta Pediatr 90:1081–1082

    Article  CAS  Google Scholar 

  133. Kusuda A, Migita K, Tsuboi M, Degawa M, Matsuoka N, Tominaga M, Kawakami A, Kawabe Y, Taguchi T, Eguchi K (1999) Successful treatment of adult-onset Henoch-Schonlein purpura nephritis with high-dose immunoglobulins. Int Med 38(4):376–379

    CAS  Google Scholar 

  134. Rostoker G (2001) Schonlein-Henoch purpura in children and adults: diagnosis, pathophysiology and management. Biodrugs 15(2):99–138

    PubMed  CAS  Google Scholar 

  135. Iqbal H, Evans A (2005) Dapsone therapy for Henoch-Schonlein purpura: a case series. Arch Dis Childhood 90(9):985–986

    CAS  Google Scholar 

  136. Ilan Y, Naparstek Y (1991) Schonlein-Henoch syndrome in adults and children. Semin Arthr Rheum 21(2):103–109

    CAS  Google Scholar 

  137. Uppal SS, Hussain MA, Al-Raqum HA, Nampoory MR, Al-Saeid K, Al-Assousi A, Abraham M, Malaviya AN (2006) Henoch-Schonlein’s purpura in adults versus children/adolescents: A comparative study. Clin Exp Rheum 24(2 Suppl 41):S26–S30

    CAS  Google Scholar 

  138. Garcia-Porrua C, Calvino MC, Llorca J, Couselo JM, Gonzalez-Gay MA (2002) Henoch-Schonlein purpura in children and adults: clinical differences in a defined population. Semin Arthr Rheum 32(3):149–156

    Google Scholar 

  139. Al-Sheyyab M, El-Shanti H, Ajlouni S, Sawalha D, Daoud A (1995) The clinical spectrum of Henoch-Schonlein purpura in infants and young children. Eur J Pediatr 154(12):969–972

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. University of Medicine and Dentistry of New Jersey, One Robert Wood Johnson Place, New Brunswick, NJ, 08903, USA

    Ellen C. Ebert

Authors
  1. Ellen C. Ebert
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Ellen C. Ebert.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ebert, E.C. Gastrointestinal Manifestations of Henoch-Schonlein Purpura. Dig Dis Sci 53, 2011–2019 (2008). https://doi.org/10.1007/s10620-007-0147-0

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-007-0147-0

Keywords

Search

Navigation