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Small Intestinal Infarction Associated with Henoch-Schöenlein Purpura

Journal of the Korean Pediatric Society 2002;45(1):125-130.
Published online January 15, 2002.
Small Intestinal Infarction Associated with Henoch-Schöenlein Purpura
Myung Ki Han1, Yu In Park1, Jeong Ho Kim1, Jung Joo Lee1, Hye Young Kang2
1Department of Pediatrics, Kangnung Hospital, College of Medicine, Ulsan University, Kangnung, Korea
1Department of Pediatrics, Kangnung Hospital, College of Medicine, Ulsan University, Kangnung, Korea
2Yonsei Pediatric Clinic, Korea
Henoch-Schöenlein 자반증에 병발한 장경색 1례
한명기1, 박유인1, 김정호1, 이정주1, 강혜영2
1울산대학교 의과대학 강릉병원 소아과
1울산대학교 의과대학 강릉병원 소아과
2연세소아과
Correspondence: 
Yu In Park, Email: yipark@knh.co.kr
Abstract
Henoch-Schöenlein purpura, also known as anaphylactoid purpura, is characterized by palpable purpura, colicky abdominal pain, gastrointestinal hemorrhage, arthralgias, and renal involvement. Histopathologically, the condition represents a vasculitis, and in fact, it may be the most common vasculitis syndrome affecting children. The pathogenesis of Henoch-Schöenlein purpura remains poorly understood, but it is postulated that an unknown antigenic stimulus causes elevation of circulating IgA and that complement activation leads to necrotizing vasculitis. All of its clinical features are attributable to wide spread vasculits. Abdominal pain is the most common gastrointestinal symptom, but intestinal bleeding and intussusception may occur. Mesenteric vasculitis is a rare but potentially serious complication of systemic vasculitis. It is reported in association with rheumatoid arthritis, systemic lupus erythematosus, scleroderma, polyarteritis nodosa, and giant cell arteritis in adult patients. Typical features are diffuse non-specific abdominal pain progressing on occasion to gastrointestinal hemorrhage, perforation, or more rarely infarction. Fortunately intestinal infarction is a rare complications, but if present carries a high chance of mortality, and swift management of the underlying vasculitis is crucial. We describe here an unusual case of a small intestinal infarction associated with Henoch-Schöenlein purpura caused by mesenteric vasculitis.
Key Words: Henoch-Schö, enlein purpura, intestinal infarction


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