Abstract

HENOCH-SCHOENLEIN PURPURA WITH GASTROINTESTINAL INVOLVEMENT IN AN ADULT PATIENT

Paul Justin D. Belvis, M.D.
1st Year Gastroenterology Fellow, Manila Doctors Hospital

Clinical Presentation: This is a case of a 47-year-old male who presented with a three-week history of abdominal pain and progressive rashes. Three weeks prior to admission, he developed colicky abdominal pain preceding meals followed by non-pruritic, erythematous maculopapular rashes on both thighs. He was given cloxacillin with no relief of symptoms. Two weeks PTA, rashes started spreading centrifugally to his legs and abdomen with vesicular lesions that rupture with mechanical trauma. He also had five bouts of melena with associated fatigue and anorexia. Five days PTA, rashes spread to the head, palms, and soles. He was admitted at a hospital in the Netherlands where a skin biopsy revealed IgA Vasculitis. Work-up done revealed anemia with a hemoglobin of 73g/L prompting an EGD which revealed Esophagitis and was given pantoprazole and repatriated to the Philippines. On admission, he had joint pains on his wrists and phalanges with four episodes of hematochezia approximately 150cc to 200cc per bout. EGD and colonoscopy done revealed nodular duodenal mucosa with duodenitis and multiple ileal ulcers with biopsies taken. Histopathology of the duodenal mucosa revealed a tubular adenoma and the ileal ulcers revealed chronic focally active ileitis with ulcer, hemorrhage and glandular atypia likely reactive. He was given pantoprazole, prednisone, clobetasol cream and was discharged with noted gradual resolution of rashes with no recurrence of bleeding on subsequent follow-ups.

Keywords: Henoch–Schönlein purpura, Gastrointestinal involvement, Gastrointestinal bleeding, Leukocytoclastic vasculitis, Adult

Important Dates to Remember

JRRE Activities
2023-2024
Proposed Dates
Resumption of face-to-face Evidence-Based Medicine Workshop
Venue to be announced once finalized.
July 21, 2023 (Friday), 1-5pm
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September 23, 2023
December 16, 2023
March 2024 (During the JAC)
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