A CASE OF ADULT ONSET HENOCH-SCHÖNLEIN PURPURA WITH GASTROINTESTINAL LESIONS ESPECIALLY MORE SEVERE IN THE ANTRUM OF THE STOMACH

Abstract

A 37-year-old man, who had been diagnosed as having Henoch-Schönlein Purpura (HSP) based on the presence of purpura on his lower extremities, was admitted to our hospital for severe abdominal pain, especially in the epigastric area. He was treated with steroids after admission and the pain was swiftly alleviated. We endoscopically observed active lesions of the stomach, duodenum and followed-up these lesions during the course of the illness. The most severe change was found in the antrum and the angular region of the stomach including mucosal congestion, redness, petechia, multiple ulcers, hemorrhagic blebs and a hematoma -like protru-sion. The appearance of the gastrointestinal lesions correlated with the illness in this patient's case. Recognizing these typical lesions in the right clinical circumstances is crucial for the early diagnosis of HSP presenting with predominantly GI symptoms. Endoscopy can be useful in the diagnosis of HSP, especially for patients without the typical skin rash.