A Case of Adult Onset Schoenlein-Henoch Purpura Presenting as an Acute Abdomen

Abstract

A 25-year-old woman presented at our hospital with abdominal pain and diarrhea, was diagnosed as infective colitis and was given by antibiotics for 7 days. Seventeen days after discharge, she presented again to our hospital complaining of lower abdominal pain, diarrhea, bloody stools, and purpura of the limbs. She was hospitalized for further treatment. Abdominal CT imagery showed slight ascites and edema from the ileum to the entire colon. Colonoscopy showed scattered aphtha in the rectosigmoid colon. A kidney biopsy was performed to assess marked proteinuria. The pathological examination revealed findings suggestive of purpuric nephropathy. Taken together, these observations indicated a diagnosis of adult onset Schoenlein-Henoch purpura. She was treated with 30 mg/day of prednisolone, resulting in improvement of the colitis, and she was discharged on the 83rd hospital day. Although an acute abdomen accompanied by Schoenlein-Henoch purpura is extremely rare in adults, it is important to consider this disorder in the differential diagnosis of idiopathic colitis associated with characteristic purpura or proteinuria.