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Gastroenterology Research and Practice
Volume 2010, Article ID 597648, 7 pages
http://dx.doi.org/10.1155/2010/597648
Case Report

Henoch-Schonlein Purpura—A Case Report and Review of the Literature

1Gastroenterology, Montefiore Medical Center, North Division, 600, E 233rd street, Bronx, NY 10466, USA
2Internal Medicine, Montefiore Medical Center, North Division, 600, E 233rd street, Bronx, NY 10466, USA
3Department of Pathology, Montefiore Medical Center, North Division, 600, E 233rd street, Bronx, NY 10466, USA
4Clinical Medicine, New York Medical College, Valhalla, NY 10595, USA

Received 30 October 2009; Accepted 17 March 2010

Academic Editor: Nirmal S. Mann

Copyright © 2010 Amit B. Sohagia et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We describe a case of an adolescent male with Henoch-Schonlein purpura (HSP), presenting with cutaneous and gastrointestinal manifestations. Endoscopy revealed diffuse ulcerations in the stomach, duodenum, and right colon. Biopsies revealed a leukocytoclastic vasculitis in the skin and gastrointestinal tract. Steroid therapy led to complete resolution of the symptoms. HSP is the most common childhood vasculitis, and is characterized by the classic tetrad of nonthrombocytopenic palpable purpura, arthritis or arthralgias, gastrointestinal and renal involvement. It is a systemic disease where antigen-antibody (IgA) complexes activate the alternate complement pathway, resulting in inflammation and small vessel vasculitis. Mild disease resolves spontaneously, and symptomatic treatment alone is sufficient. Systemic steroids are recommended for moderate to severe HSP. The prognosis depends upon the extent of renal involvement, which requires close followup. Early recognition of multiorgan involvement, especially outside of the typical age group, as in our adolescent patient, and appropriate intervention can mitigate the disease and limit organ damage.