Gastrointestinal Manifestations and Complications of Henoch-Schönlein Purpura

Background: Henoch-Schönlein purpura (HSP) is a systemic vasculitic disorder commonly affecting young children. Gastrointestinal (GI) involvement is frequently seen, and it varies from mild symptoms to severe complications.

Methods: In the 5 years from July 1995 to June 2000, 208 children were diagnosed with HSP in our hospital. There were 116 males and 92 females with ages ranging from 9 months to 15 years (mean, 6.4 years; median, 5.5 years). Their medical records were reviewed. We focused on their gastrointestinal manifestations and complications. The hospital course and management of these patients were also analyzed.

Results: GI manifestations were present in 162 cases (77.8%), and among them the most common presentation was colicky abdominal pain in 159 cases (98.1%), followed by vomiting in 64 cases (39.5%). Severe complications included massive GI bleeding in 5 patients, intussusception in 1, protein-losing enteropathy in 1, and a patient with pancreatitis. GI symptoms occurred before the manifestation of skin lesions in 41 patients (25.3%). Five of them underwent a laparotomy. Four cases were operated on due to suspicion of acute appendicitis or peritonitis. Another patient had an emergent operation due to ileo-ileo intussusception.

Conclusions: GI manifestations of HSP are common. Colicky abdominal pain was the most common GI manifestation of Henoch-Schönlein purpura. Some patients may have GI complications, but those requiring surgical intervention in our study were rare.