Summary
Gastrointestinal manifestations of Henoch-Schönlein purpura commonly include abdominal pain and gastrointestinal bleeding as well as extraintestinal signs and symptoms. We report here on a 24-year-old man with gastrointestinal pain in whom the classical features of Henoch-Schönlein purpura appeared only 6 days after acute abdominal symptoms. At endoscopic investigation inflammation with aphthous lesions was detected at the terminal ileum, which is a common feature of Crohn's disease. The observation that vasculitic disorders such as Henoch-Schonlein purpura can present with inflammatory lesions at the terminal ileum which are indistinguishable from those of Crohn's disease underlines the potential vasculitic basis of the latter condition.
Similar content being viewed by others
Abbreviations
- HSP:
-
Henoch-Schönlein purpura
References
Cream JJ, Gumpel JM, Peachey RDG (1970) Schoenlein-Henoch purpura in adults. Q J Med 39:461–483
Devaney KO, Travis WD, Hoffman G, Leariff R, Lebovis R, Franci AS (1990) Interpretation of head and neck biopsies in Wegener's granulomatosis. Am J Surg Pathol 14:555–546
Farmer RG, Hawk WA, Turnbull RB Jr (1975) Clinical patterns in Crohn's disease: a statistical study of 615 cases. Gastroenterology 68:627–635
Goldbloom RB, Drummond KN (1968) Anaphylactoid purpura with massive gastrointestinal hemorrhage and glomerulonephritis. Am J Dis Child 116:97–102
Goldstein AR, White RHR, Akuse R, Chantler C (1992) Long-term follow-up of childhood Henoch-Sch6nlein nephritis. Lancet 339:280–282
Greenstein AJ, Janowitz HD, Sachar DB (1976) The extra-intestinal complications of Crohn's disease and ulcerative colitis: A study of 700 patients. Medicine 55:401–412
Ja V, Probert CS, Mackay EH, Williams GT, Mayberry JF (1992) Granulomas in inflammatory bowel disease: are they of diagnostic or aetiologic significance? Eur J Gastroenterol Hepatol 4:15–17
Martinex-Frontanilla LA, Northway JD (1984) Surgical complications in Henoch-Schönlein syndrome. J Pediatr Surg 19:434–436
Peeters AJ, van den Wall Bake AWL, Dahe MR, Breedveld FC (1990) Inflammatory bowel disease and ankylosing spondylitis associated with cutaneous vasculitis, glomerulonephritis, and circulating IgA immune complexes. Ann Rheum Dis 49:638–640
Rankin G, Watts HD, Melnyk CS, Kelley ML (1979) National cooperative Crohn's disease study: extraintestinal manifestations and perianal complications. Gastroenterology 77:914–920
Salgame P, Abrams JS, Clayberger C, Goldstein H, Convit J, Modlin RL, Bloom BR (1991) Differing lymphokine profiles of functional subsets of human CD4 and CD8 T cell clones. Science 254:279–282
Sams WM Jr (1980) Necrotizing vasculitis. J Am Acad Dermatol 3:1–13
Shum DT, Guenther L (1990) Metastatic Crohn's disease. Arch Dermatol 126:645–648
Tomamasa T, Hsu JY, Itch K, Kurume T (1987) Endoscopic findings in pediatric patients with Henoch-Sch6nlein purpura and gastrointestinal symptoms. J Pediatr Gastroenterol Nutr 6:725–729
Wakefield AJ, Sawyerr AM, Dhillon AP, Pittilo RM, Rowles PM, Lewis AAM, Pounder RE (1989) Pathogenesis of Crohn's disease: multifocal gastrointestinal infarction. Lancet II:1057–1062
Wakefield AJ, Sankey EA, Dhillon AP, Sawyerr AM, More L, Sim R, Pittilo R, Rowles PM, Hudson M, Lewis AAM, Pounder RE (1991) Granulomatous vasculitis in Crohn's disease. Gastroenterology 110:1279–1287
White RHR (1991) Henoch-Sch6nlein purpura. In: Churg A, Churg J (eds) Systemic vasculitides. Igaku-Shoin, New York, pp 203–217
Yamamura M, Uyemura K, Deans RJ, Weinberg K, Rea TH, Bloom BR, Modlin RL (1991) Differing protecting responses to pathogens: cytokine profiles in leprosy lesions. Science 254:277–279
Yentis J (1973) Henoch-Schoenlein purpura mimicking acute appendicitis and Crohn's disease. Br J Radiol 46:555–556
Zeek PM, Smith CC, Weeter JC (1948) Studies on periarteritis nodosa. III. The differentiation between the vascular lesions of periarteritis nodosa and of hypersensitivity. Am J Pathol 24:889–901
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Scherbaum, W.A., Kaufmann, R., Vogel, U. et al. Henoch-Schönlein purpura with ileitis terminalis. Clin Investig 71, 564–567 (1993). https://doi.org/10.1007/BF00208482
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00208482