Schoenlein-Henoch purpura in adulthood (gastrointestinal manifestation andendoscopy)

During a 15-year-period 62 adult patients were admitted with diagnosis of S choenlein-Henoch purpura in our hospital. 25 female and 37 male patients ra nged from 30-87 years (mean: 59.5 years) presenting with cutaneous, joint, renal and particularly abdominal involvement were investigated retrospectiv ely. During the course of the disease, all patients developed purpuric,rash (100%), 14 (22,5%) patients had joint symptoms and renal involvement occur red in 12 (19,3%) patients. In this study, we discuss 15 (24%) patients wit h gastrointestinal symptoms appearing in Henoch's purpura. Analysis of the gastrointestinal clinical features revealed: Abdominal pain 13 (86%), massi ve colorectal bleeding 3 (20%), occult blood loss 10 (66%) vomiting 6 (40%) and diarrhea in 3 (20%) patients. Surgical consultation was obtained for 4 of the 15 patients and laparotomy was performed in 2 patients. All the pat ients underwent lower and upper endoscopic examination, in 3 cases the auth ors saw purpuric mucosal lesions in duodenum and in 8 patients were also fo und coin-like elevated lesions, additionally, biopsy from colonic lesions s howed leukocytoclastic vasculitis. It is concluded that endoscopy may play a very important role in the diagnosis and treatment of Schoenlein-Henoch p urpura.