| A Case of Henoch-Schönlein Purpura with Suspicious Focal Bowel Necrosis in an Adult |
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Su Jin Kim, Cheol Hee Park, So Yeon Kim, In Joung Lee, Chul Min Park, Chang Beom Cho, Jin Woo Kwon, Ji Won Park, Kyung Rim Huh, Kyoung Oh Kim, Il Hyun Baek, Kyo Sang Yoo, Jong Hyeok Kim, Choong Kee Park |
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Department of Internal Medicine, Hallym University College of Medicine, Anyang, Korea
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| 성인에서 국소 장괴사를 동반한 Henoch-Schönlein Purpura 1예 |
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김수진, 박철희, 김소연, 이인정, 박철민, 조창범, 권진우, 박지원, 허경림, 김경오, 백일현, 유교상, 김종혁, 박충기 |
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한림대학교 의과대학 내과학교실 |
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| Abstract |
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Henoch-Schönlein purpura (HSP) is a vasculitis of the small vessels of the skin, joints, gastrointestinal tract, and kidneys characterized by immunoglobulin A deposits in the involved organs. HSP is typified by the classic tetrad of purpura, arthralgia, abdominal pain, and renal involvement. It is common in childhood, but may also occur in adults and can be accompanied by severe complications. Gastrointestinal symptoms occur in up to 85% of patients, and gastrointestinal involvement can manifest as severe problems including intussusception, obstruction, and perforation. The disease course is often self-limited, but severe manifestations occasionally require surgical intervention. We report the case of a 24-year-old man with HSP who presented with abdominal pain and vomiting. Computerized tomography revealed thickening of the ileal wall and multifocal disrupted prominent mucosal enhancement. These findings suggested hemorrhagic enteritis and mucosal necrosis. After treatment with high dose corticosteroids, the lesion improved and surgical intervention was avoided. Our experience suggests that corticosteroid therapy may help in controlling HSP with suspicious small bowel necrosis. (Intest Res 2011;9:148-152) |
| Key Words:
Henoch-Schö, nlein Purpura, Bowel Necrosis, Steroids, Renal Involvement, Leukocytoclastic Vasculitis |
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