A CASE OF SCHOENLEIN HENOCH PURPURA WITH DIAGNOSTIC CONTRIBUTION OF IMMUNOHISTOCHEMICAL STUDY ON BIOPSY SPECIMEN

Abstract

A 60-year-old man with liver cirrhosis was admitted to our emergency unit because of epigastric pain, melena and purpura. By emergency endoscopy, shallow ulceration was found in the antrum and diffuse submucosal hemorrhage from the upper body down to the duodenal bulb. By colonoscopic examination, hemorrhagic lesions were also observed in the large bowel. Ig-A depositions were detected in the capillary wall of the stomach, duodenum and colon by immunohistochemical study of the biopsy specimens . Aiagnosis of Schoenlein Henoch Purpura was consequently made. On the basis of hospitalization with prednisolone administration and plasmapheresis, clinical manifestations and endoscopic findings were improved in four months. The immunohistochemical study of the biopsy specimens was useful to distinguish the intestinal mucosal lesions with Schoenlein Henoch Purpura from those with chronic liver disease .