A Case of Ischemic Enteritis Due to Leukocytoclastic Vasculitis in Children

Abstract

An 8 year-old female was admitted to our hospital because of a 10-day history of the left upper quadrant abdominal pain and vomiting. Laboratory findings showed a bloody stool, proteinuria, an elevation of C-reactive protein and leukocytosis, but she didn't have purpura which is commonly present in Henoch-Schoenlein syndrome (HSS) . Upper gastrointestinal series showed the localized narrowing of the proximal jejunum. Surgical findings showed both severe edema and redness from the duodenum to the jejunum and a severe stricture of the jejunum. Only the partial resection of the jejunum was performed. The remnant lesion in the duodenum has been following endoscopically. Pathological findings of the jejunum showed leukocytoclastic vasculitis in the submucosa. These findings resembled those of HSS, but IgA and C3 deposits which are characteristic in HSS were not found in the jejunum under immunofluorescent stainings. The post-operative course was uneventful and endoscopic findings of the duodenum improved spontaneously after surgery. These clinical and pathological findings suggest this case most resembles HSS without purpura, although IgA and C3 deposits were not found, and it was interesting that the duodenal remnant lesion showed a spontaneous improvement after surgery.