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Severe Henoch‐Schönlein Purpura with Intestinal Hemorrhagic Ulcers: Treated by Steroid Pulse Therapy
Author(s) -
KATAOKA Hiromi,
JOH Takashi,
OHSHIMA Tadayuki,
TAKAHASHI Nobuo,
WATANABE Katsushi,
IMAEDA Kenrou,
SASAKI Makoto,
MIYATA Mitsuki,
TSUCHIDA Kenji,
IKAI Masayuki,
SENOO Kyoji,
YOKOYAMA Yoshifumi,
ITOH Makoto
Publication year - 1997
Publication title -
digestive endoscopy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.5
H-Index - 56
eISSN - 1443-1661
pISSN - 0915-5635
DOI - 10.1111/j.1443-1661.1997.tb00489.x
Subject(s) - medicine , purpura (gastropod) , henoch schonlein purpura , prednisolone , gastroenterology , duodenum , erythema , rash , surgery , dermatology , vasculitis , ecology , disease , biology
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.