A Case of Henoch Schönlein Purpura with Gastrointestinal Bleeding Due to Jejunal Ulcer by Capsule Endoscopy

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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