The characteristics of video capsule endoscopy in pediatric Henoch–Schönlein purpura with gastrointestinal symptoms

Abstract Background Henoch–Schönlein purpura (HSP) is a systemic small-vessel vasculitis that commonly affects gastrointestinal tract. The video capsule endoscopy (VCE) characteristics of pediatric HSP patients were rarely investigated. Methods Patients diagnosed with HSP by VCE examination at our hospital from February 2010 to January 2019 are analyzed. The clinical features, laboratory findings, and the characteristics of VCE findings are studied. Results There are 30 patients enrolled in this investigation from February 2010 to January 2020. The mean age of these patients is 96.9±35.8 months, and the most frequent finding of VCE is mucosal erosion, which account for 69 % of the patients, and followed by mucosal erythema or petechia accounted for 79.3 % of the patients. Regarding to the disease location detected by endoscopy, jejunum is the most common involved part of the gastrointestinal tract in pediatric HSP patients. All the patients had jejunum involved except in one patient the VCE did not pass through the pylorus. One third of the patients involved the descent part of duodenum. No side effects are observed in this study. Conclusions VCE is safe and effective in the diagnosis of gastrointestinal involved HSP patients with or without typical skin purpura. Jejunum is the most common involve location in gastrointestinal.

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The characteristics of video capsule endoscopy in pediatric Henoch–Schönlein purpura with gastrointestinal symptoms

Pediatric Rheumatology ◽

10.1186/s12969-020-00471-4 ◽

2020 ◽

Vol 18 (1) ◽

Author(s):

Youhong Fang ◽

Kerong Peng ◽

Hong Zhao ◽

Jie Chen

Keyword(s):

Gastrointestinal Tract ◽

Capsule Endoscopy ◽

Gastrointestinal Symptoms ◽

Video Capsule Endoscopy ◽

Small Vessel Vasculitis ◽

Henoch Schonlein Purpura ◽

Laboratory Findings ◽

Abdominal Symptoms ◽

Schonlein Purpura ◽

Henoch Schönlein Purpura

Abstract Background Henoch–Schönlein purpura (HSP) is a systemic small-vessel vasculitis also named IgA vasculitis that commonly affects the gastrointestinal tract. The video capsule endoscopy (VCE) characteristics of pediatric HSP patients are rarely reported. Methods Patients diagnosed with HSP and analyzed by VCE examination at our hospital from February 2010 to January 2019 are enrolled. The clinical features, laboratory findings, and the characteristics of VCE findings are studied. Results There are 30 patients enrolled in this investigation from February 2010 to January 2020. The mean age of these patients is 96.9 ± 35.8 months, and the most frequent finding of VCE is mucosal erosion, which account for 79.3% of the patients, and followed by mucosal erythema or petechia accounted for 69% of the patients. Regarding the disease location detected by endoscopy, jejunum is the most common involved part of the gastrointestinal tract in pediatric HSP patients. All the patients had the jejunum involved except in one patient the VCE did not pass through the pylorus. One third of the patients involved the descending portion of duodenum. No side effect is observed in this study. Conclusions VCE may be an excellent adjust tool for evaluation of the gastrointestinal tract in children with abdominal symptoms without typical purpura in suspected pediatric HSP patients. VCE appears to be superior to esophagogastroduodenoscopy in detecting small intestinal lesions of HSP and has an excellent safety profile.

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Henoch-Schönlein purpura presenting with multiplex gastrointestinal manifestations and massive nephrotic syndrome in adulthood — a case report

Open Medicine ◽

10.2478/s11536-008-0060-8 ◽

2008 ◽

Vol 3 (4) ◽

pp. 521-524

Author(s):

Farkas Klaudia ◽

Molnár Tamás ◽

Nagy Ferenc ◽

Tiszlavicz László ◽

Németh István ◽

...

Keyword(s):

Nephrotic Syndrome ◽

Renal Involvement ◽

Gastrointestinal Symptoms ◽

Small Vessel Vasculitis ◽

Henoch Schonlein Purpura ◽

Intravenous Cyclophosphamide ◽

Rapid Improvement ◽

Gastrointestinal Manifestations ◽

Schonlein Purpura ◽

Henoch Schönlein Purpura

AbstractHenoch-Schönlein purpura (HSP) is a systemic small vessel vasculitis mainly affecting children. We report a case of a 49-year-old woman with severe gastrointestinal and renal involvement of HSP. Endoscopy revealed more characteristic findings in the terminal ileum than in the gastric antrum. Histological examinations of the biopsy samples from the ileum, antrum, skin and kidney confirmed the diagnosis of HSP. Parenteral corticosteroid therapy led to a rapid improvement of the gastrointestinal symptoms, but because of the excessive proteinuria intravenous cyclophosphamide therapy had to be introduced.

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Evaluation of epidemiological, clinical and laboratory findings in Henoch Schönlein purpura

Türkiye Aile Hekimliği Dergisi ◽

10.15511/tahd.20.00287 ◽

2020 ◽

Vol 24 (2) ◽

pp. 87-94

Author(s):

Ünal Akça ◽

Gülfer Akca

Keyword(s):

Henoch Schonlein Purpura ◽

Laboratory Findings ◽

Schonlein Purpura ◽

Henoch Schönlein Purpura

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Altered mean platelet volume in children with Henoch-Schonlein purpura and its association with disease activity

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1177/0004563217727015 ◽

2017 ◽

Vol 55 (3) ◽

pp. 368-372

Author(s):

Xiang Shi ◽

Wen-Chao Li ◽

Li-Jun Mo ◽

Xiao-Hong Li ◽

Yu-Zhen Luo ◽

...

Keyword(s):

Acute Phase ◽

Mean Platelet Volume ◽

Area Under The Curve ◽

Small Vessel Vasculitis ◽

Henoch Schonlein Purpura ◽

Platelet Volume ◽

Convalescent Phase ◽

Schonlein Purpura ◽

Henoch Schönlein Purpura

Background Henoch-Schonlein purpura is a systemic small-vessel vasculitis that occurs mainly in children. A review of the literature has suggested a correlation between mean platelet volume and several inflammatory disorders. However, to the best of our knowledge, any potential correlation between mean platelet volume and Henoch-Schonlein purpura has not been reported in the literature. Therefore, our study aimed to evaluate the role of mean platelet volume concentrations in patients with Henoch-Schonlein purpura. Methods This study included 97 children with Henoch-Schonlein purpura and 120 healthy individuals as controls. Results Mean platelet volume concentrations were found to be significantly lower in Henoch-Schonlein purpura patients compared with healthy controls (8.1 ± 0.86 vs. 9.4 ± 0.81, P < 0.001). Similarly, significant negative correlations were observed between mean platelet volume and neutrophil count, platelet count and erythrocyte sedimentation rate in patients with Henoch-Schonlein purpura (r=−0.327, P = 0.001; r=−0.419, P < 0.001; r=−0.255, P = 0.012). Interestingly, mean platelet volume was significantly lower in the acute phase compared with the convalescent phase of Henoch-Schonlein purpura patients (7.8 ± 0.86 vs. 8.3 ± 0.77, P = 0.002). A cut-off value for mean platelet volume was 7.85 with area under the curve of 0.726 to identify acute phase vs. convalescent phase in patients with Henoch-Schonlein purpura. Mean platelet volume was independently associated with Henoch-Schonlein purpura in logistic regression analysis (odds ratio = 0.114, 95% confidence interval = 0.053–0.243, P < 0.001). Conclusions Our results suggest that mean platelet volume is inversely associated with disease in patients with Henoch-Schonlein purpura, and mean platelet volume may be a useful marker to identify active disease in Henoch-Schonlein purpura patients.

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An unusual case of transient cortical blindness with sagittal sinus thrombosis in a case of Henoch-Schonlein purpura

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v4i2.6556 ◽

2012 ◽

Vol 4 (2) ◽

pp. 333-335 ◽

Cited By ~ 3

Author(s):

S K Samanta ◽

N Mahapatra ◽

B Aich ◽

N Sarkar ◽

A Chatterjee

Keyword(s):

Unusual Case ◽

Sinus Thrombosis ◽

Cortical Blindness ◽

Small Vessel Vasculitis ◽

Henoch Schonlein Purpura ◽

High Grade Fever ◽

Diffuse Abdominal Pain ◽

Transient Cortical Blindness ◽

Schonlein Purpura ◽

Henoch Schönlein Purpura

Introduction: Henoch-Schonlein purpura (HSP) is one of the most common causes of small vessel vasculitis in children, but sometimes may have an atypical presentation. Objective: To report an unusual case of transient cortical blindness in a patient with Henoch-Schonlein purpura. Case: A 3-year-old female child was brought with the complaint of diffuse abdominal pain and hematochezia, which was preceded by high grade fever and cough. Three days later she developed hematuria, hematemesis, melena and hemoptysis along with palpable purpura. Four days later she became irritable and developed a few episodes of generelized tonic clonic seizure, followed by cortical blindness. The CT scan of the brain showed bilateral nonenhancing occipital hypodensity. The magnetic resonance venography showed thrombosis in transverse and sigmoid sinus. She was treated with corticosteroids and her mental status and vision improved. Conclusion: The HSP can cause transient cortical blindness, and recovery is good if therapy is initiated at the appropriate time.DOI: http://dx.doi.org/10.3126/nepjoph.v4i2.6556 Nepal J Ophthalmol 2012; 4 (2): 333-335

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Koebner phenomenon in leukocytoclastic vasculitis: A case report and an updated review of the literature

SAGE Open Medical Case Reports ◽

10.1177/2050313x19850353 ◽

2019 ◽

Vol 7 ◽

pp. 2050313X1985035

Author(s):

Farah Kassam ◽

Sabrina Nurmohamed ◽

Richard M Haber

Keyword(s):

Case Report ◽

Leukocytoclastic Vasculitis ◽

Immunoglobulin A ◽

Small Vessel Vasculitis ◽

Review Of The Literature ◽

Henoch Schonlein Purpura ◽

Koebner Phenomenon ◽

Vessel Injury ◽

Schonlein Purpura ◽

Henoch Schönlein Purpura

Leukocytoclastic vasculitis is the most common form of cutaneous vasculitis. It is a neutrophilic small vessel vasculitis resulting from the deposition of circulating immune complexes. Henoch-Schonlein purpura is a systemic type of leukocytoclastic vasculitis, characterized by immunoglobulin A-mediated blood vessel injury. We present a case of Henoch-Schonlein purpura in an adult female manifesting with a vasculitic rash with Koebner phenomenon.

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Severe Disfiguring Scalp and Facial Oedema due to Henoch–Schönlein Purpura in a Child

Case Reports in Pediatrics ◽

10.1155/2020/8823611 ◽

2020 ◽

Vol 2020 ◽

pp. 1-4

Author(s):

Visvalingam Arunath ◽

Arjuna Salinda Athapathu ◽

Thabitha Jebaseeli Hoole ◽

Heshan Aruppala ◽

Asanka Rathnasri ◽

...

Keyword(s):

Soft Tissue ◽

Urine Analysis ◽

The Body ◽

Small Vessel Vasculitis ◽

Facial Oedema ◽

Normal Brain ◽

Henoch Schonlein Purpura ◽

Facial Swelling ◽

Schonlein Purpura ◽

Henoch Schönlein Purpura

Henoch–Schönlein purpura is a small vessel vasculitis that usually presents with palpable purpura, arthritis, abdominal pain, and nephritis. Subcutaneous oedema of dependent areas is common; however, oedema in the scalp is extremely rare especially in children older than two years. Here, we report a child with massive disfiguring scalp and facial oedema due to Henoch–Schönlein purpura. An eight-year-old boy presented with characteristic palpable purpuric rash and extensive disfiguring scalp and facial swelling for five days. He complained of blurred vision, vomiting, and severe headache on the day of admission. Examination revealed an ill child with extensive oedema of the face and scalp that was tender on palpation. His blood pressure was above the 99th percentile, and he had exaggerated deep tendon reflexes and extensor plantar responses. All biochemical investigations including renal function tests were normal. Noncontrast CT head showed normal brain, with marked soft tissue swelling of the scalp. Ultrasonography showed soft tissue oedema within and surrounding facial muscles without evidence of neck vessel compression. Urine analysis revealed microscopic haematuria on day 14 of the illness, and immunohistochemical staining of renal biopsy confirmed Henoch–Schönlein purpura nephritis. In conclusion, this case report presents a child with severe, disfiguring scalp and facial oedema due to Henoch–Schönlein purpura. It highlights that severe subcutaneous oedema of Henoch–Schönlein purpura can involve any part of the body not limiting to dependent areas.

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