Gastrointestinal Biopsy in Henoch-Schönlein Purpura: A Great Diagnostic Contribution

  • Imen Akkari Gastroenterology department, Farhat Hached Hospital, Sousse
  • Soumaya Mrabet Gastroenterology department, Farhat Hached Hospital, Sousse
  • Elhem Ben Jazia Gastroenterology department, Farhat Hached Hospital, Sousse
Keywords: Henoch–Schönlein purpura, gastrointestinal disease, endoscopy

Abstract

Henoch-Schönlein purpura is an IgA-mediated immune vasculitis which is characterized by purpuric lesions and osteoarticular, intestinal and sometimes renal manifestations. The histopathological substrate of this entity is leucocytoclastic vasculitis (LCV) with IgA deposits seen on immunohistochemistry. We here report the case of a 27-year-old woman with abdominal pain and cutaneous purpura. Upper and lower endoscopic exploration showed purpuric lesions in the rectum but not in the stomach. Skin biopsy revealed LCV. IgA deposits were seen only in gastric mucosa. The patient was treated with corticoids which led to improvement of both the cutaneous and digestive symptoms. This case suggests that gastrointestinal biopsies of both normal and abnormal mucosa should be taken in Henoch-Schönlein purpura, especially in patients with atypical forms.

References

  • Saulsbury FT. Clinical update: Henoch-Schönlein purpura. Lancet 2007;369:976–978.

  • Poterucha TJ, Wetter DA, Gibson LE, Camilleri MJ, Lohse CM. Histopathology and correlates of systemic disease in adult Henoch-Schönlein purpura: a retrospective study of microscopic and clinical findings in 68 patients at Mayo Clinic. J Am Acad Dermatol 2013;68:420–424.e3.

  • Ozen S, Pistorio A, Iusan SM, Bakkaloglu A, Herlin T, Brik R, et al. EULAR/PRINTO/PRES criteria for Henoch-Schonlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis 2010;69:798–806.

  • Trouillier S, André M, Delèvaux I, Mahamedi H, Affo C, Kintossou R, et al. Atteintes digestives du purpura rhumatoïde de l’adulte. Étude d’une série rétrospective de 23 patients.Rev Médecine Interne 2009;30:661–70.

  • Bouiller K, Audia S, Devilliers H, Collet E, Aubriot MH, Leguy-Seguin V, et al. Etiologies and prognostic factors of leukocytoclastic vasculitis with skin involvement: a retrospective study in 112 patients. Medicine (Baltimore) 2016;95:e4238.
  • Published: 2017-09-27

    Issue: Vol 4 No 9 (view)

    Section: Articles

    How to cite:
    Akkari, I., Mrabet, S., & Ben Jazia, E. (2017). Gastrointestinal Biopsy in Henoch-Schönlein Purpura: A Great Diagnostic Contribution. European Journal of Case Reports in Internal Medicine, 4(9). https://doi.org/https://doi.org/10.12890/2017_000662