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©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 14, 2016; 22(26): 6089-6094
Published online Jul 14, 2016. doi: 10.3748/wjg.v22.i26.6089
Published online Jul 14, 2016. doi: 10.3748/wjg.v22.i26.6089
Henoch-Schönlein purpura from vasculitis to intestinal perforation: A case report and literature review
Butsabong Lerkvaleekul, Soamarat Vilaiyuk, Division of Rheumatology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
Suporn Treepongkaruna, Division of Gastroenterology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
Pawaree Saisawat, Division of Nephrology, Department of Pediatrics, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
Pornsri Thanachatchairattana, Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
Napat Angkathunyakul, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
Nichanan Ruangwattanapaisarn, Department of Diagnostic and Therapeutic Radiology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
Author contributions: Lerkvaleekul B designed the report and collecting data; Lerkvaleekul B and Vilaiyuk S participated in patient care and writing the manuscript; Treepongkaruna S, Saisawat P, Thanachatchairattana P, Angkathunyakul N, and Ruangwattanapaisarn N participated in patient care and editing the manuscript; Angkathunyakul N provided the histology and pathology images; all authors have read and approved the final manuscript.
Institutional review board statement: This report was reviewed and approved by the Ramathibodi Hospital Institutional Review Board.
Informed consent statement: The legal guardian of the study participant provided informed written consent prior to study enrollment.
Conflict-of-interest statement: All authors declare that they have no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Soamarat Vilaiyuk, MD, Assistant Professor, Chief, Division of Rheumatology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, 270 Rama VI road, Ratchathewi, Bangkok 10400, Thailand. soamarat21@hotmail.com
Telephone: +66-2-2012865 Fax: +66-2-2011494
Received: March 28, 2016
Peer-review started: March 29, 2016
First decision: April 14, 2016
Revised: May 7, 2016
Accepted: May 21, 2016
Article in press: May 23, 2016
Published online: July 14, 2016
Peer-review started: March 29, 2016
First decision: April 14, 2016
Revised: May 7, 2016
Accepted: May 21, 2016
Article in press: May 23, 2016
Published online: July 14, 2016
Core Tip
Core tip: Henoch-Schönlein purpura (HSP) with intestinal perforation during the course of corticosteroid treatment was a rare condition. We report a HSP patient with vasculitis-induced mucosal ischemia, eventually leading to ulcer and intestinal perforation. No imaging modality could detect bowel ischemia before perforation. Histopathology of resected bowel also suggested that high-dose corticosteroids might be a contributing factor to intestinal perforation in this patient. Early treatment by surgical resection of ischemic bowel can prevent intestinal perforation and peritonitis, which are life-threatening complications.