Abstract
We present a six-year-old boy with HSP who was treated with steroids, factor 13 preparation, urinastatin, and steroid pulse therapy. However, the purpura, abdominal pain and melena gradually worsened, and renal dysfunction appeared. Steroid pulse therapy and steroid administration were repeated, and his symptoms and inspection values improved temporarily. However, abdominal pain recurred on the 24th day after onset, and emergency surgery was necessitated by gastrointestinal perforation the next day. Necrosis and a punch at the ileum 90cm to 40cm from the Bauhin valve were observed. We excised this part and anastomosed the cut ends. Histopathological examination revealed little evidence of either an unusual thrombus or vasculiti of HSP. CMV inclusion was shown by HE staining. CMV was confirmed by immunohistochemistry. CMV antigenemia was positive, and CMV enteritis was proven to be the cause of the small-bowel perforation.
