Astrointestinal Hemorrhage as an Initial Presentation of Henoch-Schönlein Purpura in an Adult Patient

Henoch-Schönlein紫斑症是一種IgA免疫複合體沉澱小血管所造成的血管炎，主要侵犯皮膚、腎絲球、關節及腸胃道。Henoch-Schönlein紫斑症在兒童經常造成腸胃道症狀但成人腸胃道症狀甚少發生於典型的紫斑症之前。我們報導一位57歲女性，最初以消化道出血、發燒、及腹部絞痛到院求診；胃鏡及大腸鏡檢查發現在胃、十二指腸、末端迴腸，迴盲瓣及直腸有多發性出血性紅斑及潰瘍。三週後病人下肢出現典型的紫斑及關節炎症狀，皮膚切片檢查證實是Henoch-Schölein紫斑症。如果內視鏡檢查發現有多發性黏膜出血病變，Henoch-Schönlein紫斑症應列入消化道出血的原因之一，因為這種出血性紅斑對類固醇的治療效果反應良好。

關鍵字

Henoch-Schönlein紫斑症；胃腸道出血

並列摘要

Henöch-Schönlein purpura (HSP) is characterized by vasculitis of small vessels with IgA-dominant immune complex deposits, and typically involves skin, glomeruli, joints and gastrointestinal tract. The gastrointestinal complications of HSP is well recognized in children, but is rarely reported in adults before the flare-up of typical skin purpuric rash. We here report a 57-year-old woman, initially presenting with gastrointestinal hemorrhage, fever and non-specific crampy abdominal pain. The gastroduodenoscopy and colonoscopy demonstrate multip1e edematous and hemorrhagic mucosal patches at stomach, duodenum, terminal ileum and rectum. Subsequently, the characteristic skin lesions and arthritis developed 3 weeks later and skin biopsy proved the diagnosis of HSP. HSP should be considered as an unusual etiology of GI bleeding if multiple hemorrhagic mucosal lesions detected by endoscopy, because it has good therapeutic effect by prednisolone.

並列關鍵字

Henoch-Schönlein purpura ； gastrointestinal bleeding

國際替代計量

Astrointestinal Hemorrhage as an Initial Presentation of Henoch-Schönlein Purpura in an Adult Patient

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