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Severe Henoch-Schönlein Purpura with Intestinal Hemorrhagic Ulcers: Treated by Steroid Pulse Therapy
Authors:Hiromi KATAOKA  Takashi JOH  Tadayuki OHSHIMA  Nobuo TAKAHASHI  Katsushi WATANABE  Kenrou IMAEDA  Makoto SASAKI  Mitsuki MIYATA  Kenji TSUCHIDA  Masayuki IKAI  Kyoji SENOO  Yoshifumi YOKOYAMA  Makoto ITOH
Abstract:Abstract: Henoch-Schönlein purpura, associated with severe duodenal hemorrhage and gastrointestinal dysfunction, was dramatically suppressed by steroid pulse therapy. A 22-year-old male was admitted with abdominal pain, purpuric rash, and neutrophilic leukocytosis. C-reactive protein was increased and coagulation Factor XIII was markedly decreased. Upper gastrointestinal endoscopy disclosed multiple ulcers and erythema with petechiae in the postbulbar duodenum. Based on laboratory findings including examination of a skin biopsy specimen, this patient was diagnosed as having Henoch-Schönlein purpura. Despite aggressive administration of prednisolone, intravenous hyperalimentation, and Factor XIII concentrate, symptoms worsened. Steroid pulse therapy was then given for three days, resulting in amelioration of all clinical findings. The duodenal ulcers showed scarring on endoscopy. Gastrointestinal complications of Henoch-Schönlein purpura. Factor XIII concentrate therapy, and pulse steroid therapy are discussed herein.
Keywords:Henoch-Schö  nlein purpura  duodenal ulcer  pulse steroid therapy  Factor XIII
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