Abstract
The patient was a 37-year-old female. An abdominal pain appeared in the latter part of March 2005, and she was first suspected as gastroenteritis and urinary tract infection. Early in April, an exanthema, similar to palpable purpura, exhibited on the cruris, and was diagnosed as Henoch-Schönlein purpura (HSP). Her gastro-intestinal symptoms exacerbated, and she was admitted to our hospital on April 22nd.Torous erythema and purpura appeared on the upper and lower abdomen, and both femorals. Laboratory examinations showed an increased WBC count, high levels of ESR and CRP. The upper endoscopy showed vasodilation and hyperlucency of the mucosa, and purpura like findings in the stomach. The vascular hyperlucency, the redness and vasodilation were observed by the colon endoscopy. Compatible findings with HSP were presented by skin biopsy, though not by the colon biopsy. We diagnosed the abdominal pain associated to HSP. After treatments with non-peroral, hemostyptic, vitamin C, and medicine for intestinal disorders and peptic ulcer, her symptoms improved, and did not worsen after the diet started. HSP is usually seen in children, and is accompanied with skin, joint, abdominal and renal symptoms. Cases with prior abdominal symptoms occur mostly to children, and are rare among adults in Japan.
