[Clinical observation of Henoch-Schonlein purpura-focus on gastrointestinal manifestation and endoscopic findings].

During the 5.5-year period from January 1988 to June 1993, there were 40 cases of Henoch-Schonlein purpura diagnosed in Chang Gung Memorial Hospital, Taipei. The diagnosis criteria is defined as a typical skin rash, which pathologic examination shows leukocytoclastic vasculitis, accompanied by any two of these major manifestations of the disease, namely gastrointestinal, renal and joint involvement. Their medical records were reviewed with respect to the clinical symptoms, laboratory findings, roentogenologic findings, endoscopic findings, and morbidity. There are 21 women and 19 men with age raging from 10 to 63 years old (mean age 35.9 years old). The male to female ratio was 1:1.1 and about 80% of the patients were at the age of fifteen or older. There was no special season distribution in this series. The main clinical features were purpuric skin rashes, 40 cases (100%), followed by gastrointestinal symptoms, 25 cases (62.5%), renal involvement, 21 cases (52.5%) and joint involvement, 19 cases (47.5%). The major gastrointestinal symptoms were abdominal pain (25 case) and bleeding from gastrointestinal tract (10 cases), and minor symptoms included vomiting (7 cases), diarrhea (1 cases) and acute pancreatitis (2 cases). Gastrointestinal endoscopy was performed in 5 cases and all had hyperemic mucosa and scattered hemorrhagic purpura in the stomach and duodenum. The characteristic hemorrhagic erosive duodenitis were observed in 3 cases. These findings may alert the gastroenterologists to take into consideration of this disease earily and thus avoid unnecessary laparotomy and complications.