Henoch-Schönlein Purpura begin with severe gastrointestinal involvement

Yıl 2014, Cilt: 45 Sayı: 4, 204 - 207, 27.09.2014

Hayrünisa Kahraman Esen , Osman Esen

Öz

Introduction: Henoch-Schönleinpurpura (HSP) is the most common vasculitis of childhood and is a multisystemic disease which is characterized by skin, joint, gastrointestinal (GI) and renal small vessels involvement.

Case: Seven-year-old male patient was admitted with complaints of nausea and vomiting and abdominal pain started three days ago. Laparotomy was performed to the patient with the diagnosis of acute abdominal pain. Any other pathology than the jejunum edema was observed in the first 10 cm field was not observed. Appendectomy performed and abdomen was closed. Postoperative fifth day pain in the knee joint and melena had occurred. In the lower and upper gastrointestinal endoscopy, diffuse hyperemia and hemorrhage were observed in the gastric mucosa, duodenum and rectum. Intravenous steroids treatment was started. Skin rashes were observed on the arms of the patient at 11. day of hospitalization. The patient who response to steroid therapy was discharged with healing at the 15th day of hospitalization.

Discussion: Purpuric skin lesions are the most common finding in the HSP and generally observed before the GI involvement. In the situation of the GI involvement occurred before the skin involvement, the abdominal pain might be similar to the appendicitis pain.

Key words: Henoch-Schönlein Purpura, severe system involvement, gastrointestinal bleeding. 

Anahtar Kelimeler

Henoch-Schönlein purpura, severe system involvement, gastrointestinal bleeding.CİLT: 45 YIL: 2014 SAYI: 4ZEYNEP KAMİL TIP BÜLTENİ 2014;45:204-7

Ağır gastrointestinal sistem tutulumu ile başlayan Henoch-Schönlein Purpurası

Öz

Giriş-Amaç: Henoch-Schönlein purpurası (HSP), çocukluk çağının en sık görülen vasküliti olup, cilt, eklem, gastrointestinal sistem (GİS) ve böbreklerdeki küçük çaplı damarların tutulumuyla karakterize multisistemik bir hastalıktır.

Olgu: Yedi yaşında, erkek hasta 3 gün önce başlayan karın ağrısı, bulantı ve kusma şikâyetleri ile başvurdu. Akut batın tanısı ile hastaya laparatomi uygulandı ve jejenum ilk 10 cm’lik alanda öem dışıda patoloji göümedi. Apendektomi yapıarak batı kapatıdı Postoperatif beşnci güde diz ekleminde ağıve melenasıoldu. Alt ve üt Gİ endoskopisinde gastrik mukoza, duedonum ve rektumda diffü hiperemi ve kanama izlendi. Vasküit tanııile intravenö steroid tedavisi başandı Hastada yatışıı 11.güüde kollarıda deri döütüeri izlendi. Steroid tedavisine yanı alıan hasta yatışıı 15. güüşfa ile taburcu edildi.

Tartışma - Sonuç: HSP de purpurik cilt lezyonları en yaygın bulgu olup genellikle GİS tutulumundan önce görülür. GİS tutulumu cilt tutulumundan önce görüldüğü durumlarda karın ağrısı apandisit tablosuna benzemektedir.

Anahtar kelimeler: Henoch-Schönlein purpurası, ağır sistem tutulumu, GİS kanama

Anahtar Kelimeler

Henoch-Schönlein purpurası, ağır sistem tutulumu, GİS kanama.

Kaynakça

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