Endoscopy 2014; 46(11): 981-986
DOI: 10.1055/s-0034-1377757
Case series
© Georg Thieme Verlag KG Stuttgart · New York

Gastrointestinal bleeding in adult patients with Henoch–Schönlein purpura

Eon Jeong Nam
1  Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
,
Gun Woo Kim
1  Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
,
Jong Wan Kang
1  Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
,
Churl Hyun Im
1  Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
,
Seong Woo Jeon
1  Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
,
Chang-Min Cho
1  Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
,
Ji Yun Jeong
2  Department of Pathology, Kyungpook National University School of Medicine, Daegu, Republic of Korea
,
Ji Young Park
2  Department of Pathology, Kyungpook National University School of Medicine, Daegu, Republic of Korea
,
Yun Jin Jang
3  Department of Radiology, Kyungpook National University School of Medicine, Daegu, Republic of Korea
,
Young Mo Kang
1  Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Republic of Korea
› Author Affiliations
Further Information

Publication History

submitted29 July 2013

accepted after revision12 June 2014

Publication Date:
16 October 2014 (eFirst)

We investigated the clinical and endoscopic features of gastrointestinal lesions in adults with Henoch–Schönlein purpura (HSP) causing gastrointestinal bleeding. The study included 24 adult HSP patients with gastrointestinal hemorrhage who underwent both upper gastrointestinal endoscopy and colonoscopy. The controls were 27 adult HSP patients without gastrointestinal hemorrhage. Patients with gastrointestinal bleeding showed higher frequencies of purpura on the upper extremities and trunk, and of elevated serum C-reactive protein (CRP). The rate of concurrent lesions in both the upper and lower gastrointestinal tracts was 91.7 %. The second portion of duodenum and terminal ileum were most frequently and severely involved. Leukocytoclastic vasculitis was detected in severe lesions and was significantly associated with mucosal ischemic changes. Most lesions (95.7 %) dramatically improved after corticosteroid therapy. This study suggests that both upper and lower gastrointestinal examinations are necessary for proper evaluation of gastrointestinal bleeding in patients with HSP.