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Published in: Journal of Medical Case Reports 1/2010

Open Access 01-12-2010 | Case report

Abdominal wall and labial edema presenting in a girl with Henoch-Schönlein purpura: a case report

Authors: Rania Hiram-Karasmanis, Ronald Garth Smith, Maria Radina, Donald Allen Soboleski

Published in: Journal of Medical Case Reports | Issue 1/2010

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Abstract

Introduction

Henoch-Schönlein purpura is a common immunoglobulin A-mediated vasculitic syndrome in children, characterized by purpuric rash, arthritis and abdominal pain. Renal involvement, manifested by the presence of hematuria and/or proteinuria, is also frequently seen. In most cases, patients with this disease achieve complete recovery, but some progress to renal impairment. Gastro-intestinal manifestations are present in two-thirds of affected patients and range from vomiting, diarrhea, and peri-umbilical pain to serious complications such as intussusception and gastrointestinal hemorrhage.

Case presentation

We report the case of a 7-year-old Caucasian girl who presented with abdominal pain, labial swelling, and a large abdominal ecchymosis two weeks after having been diagnosed with Henoch-Schönlein purpura. A computed tomography scan revealed abdominal wall edema extending to the groin, without any intra-abdominal pathology. She was successfully treated with intravenous steroids.

Conclusion

Circumferential anterior abdominal wall edema and labial edema have never been reported previously, to the best of our knowledge, as a complication of Henoch-Schönlein purpura. These findings further contribute to the wide spectrum of manifestations of this disorder in the literature, aiding in its recognition and management.
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Literature
1.
go back to reference Saulsbury FT: Henoch-Schönlein purpura in children. Report of 100 patients and review of the literature. Medicine. 1999, 78: 395-409. 10.1097/00005792-199911000-00005.CrossRefPubMed Saulsbury FT: Henoch-Schönlein purpura in children. Report of 100 patients and review of the literature. Medicine. 1999, 78: 395-409. 10.1097/00005792-199911000-00005.CrossRefPubMed
2.
go back to reference Mills JA, Michel BA, Bloch DA, Calabrese LH, Hunder GG, Arend WP, Edworthy SM, Fauci AS, Leavitt RY, Lie JT: The American College of Rheumatology 1990 criteria for the classification of Henoch-Schönlein purpura. Arthritis & Rheumatism. 1990, 33: 1114-1121.CrossRef Mills JA, Michel BA, Bloch DA, Calabrese LH, Hunder GG, Arend WP, Edworthy SM, Fauci AS, Leavitt RY, Lie JT: The American College of Rheumatology 1990 criteria for the classification of Henoch-Schönlein purpura. Arthritis & Rheumatism. 1990, 33: 1114-1121.CrossRef
3.
go back to reference Ozen S, Ruperto N, Dillon MJ, Bagga A, Barron K, Davin JC, Kawasaki T, Lindsley C, Petty RE, Prieur AM, Ravelli A, Woo P: EULAR/PReS e ndorsed consensus criteria for the classification of childhood vasculitides. Annals of the Rheumatic Diseases. 2006, 65: 936-941. 10.1136/ard.2005.046300.CrossRefPubMed Ozen S, Ruperto N, Dillon MJ, Bagga A, Barron K, Davin JC, Kawasaki T, Lindsley C, Petty RE, Prieur AM, Ravelli A, Woo P: EULAR/PReS e ndorsed consensus criteria for the classification of childhood vasculitides. Annals of the Rheumatic Diseases. 2006, 65: 936-941. 10.1136/ard.2005.046300.CrossRefPubMed
4.
go back to reference Bailey M, Chapin W, Licht H, Reynolds JC: The effects of vasculitis on the gastrointestinal tract and liver. Gastroenterology Clinics of North America. 1998, 27: 747-782. 10.1016/S0889-8553(05)70032-7.CrossRefPubMed Bailey M, Chapin W, Licht H, Reynolds JC: The effects of vasculitis on the gastrointestinal tract and liver. Gastroenterology Clinics of North America. 1998, 27: 747-782. 10.1016/S0889-8553(05)70032-7.CrossRefPubMed
5.
go back to reference Venuta A, Bertolani P, Garetti E, Venturelli C, Predieri B, Muttini ED, Compagni E: Hemorrhagic ascites in a child with Henoch-Schönlein purpura. Journal of Pediatric Gastroenterology & Nutrition. 1999, 29: 358-359.CrossRef Venuta A, Bertolani P, Garetti E, Venturelli C, Predieri B, Muttini ED, Compagni E: Hemorrhagic ascites in a child with Henoch-Schönlein purpura. Journal of Pediatric Gastroenterology & Nutrition. 1999, 29: 358-359.CrossRef
6.
go back to reference Bissonnette R, Dansereau A, D'Amico P, Pateneaude JV, Paradis J: Perforation of large and small bowel in Henoch-Schönlein purpura. International Journal of Dermatology. 1997, 36: 361-363.CrossRefPubMed Bissonnette R, Dansereau A, D'Amico P, Pateneaude JV, Paradis J: Perforation of large and small bowel in Henoch-Schönlein purpura. International Journal of Dermatology. 1997, 36: 361-363.CrossRefPubMed
7.
go back to reference Cheung KM, Mok F, Lam P, Chan KH: Pancreatitis associated with Henoch-Schönlein purpura. Journal of Paediatrics & Child Health. 2001, 37: 311-313.CrossRef Cheung KM, Mok F, Lam P, Chan KH: Pancreatitis associated with Henoch-Schönlein purpura. Journal of Paediatrics & Child Health. 2001, 37: 311-313.CrossRef
8.
go back to reference Viola S, Meyer M, Fabre M, Tounian P, Goddon R, Dechelotte P, Valayer J, Gruner M, Bernard O: Ischemic necrosis of bile ducts complicating Schönlein-Henoch purpura. Gastroenterology. 1999, 117: 211-214. 10.1016/S0016-5085(99)70569-X.CrossRefPubMed Viola S, Meyer M, Fabre M, Tounian P, Goddon R, Dechelotte P, Valayer J, Gruner M, Bernard O: Ischemic necrosis of bile ducts complicating Schönlein-Henoch purpura. Gastroenterology. 1999, 117: 211-214. 10.1016/S0016-5085(99)70569-X.CrossRefPubMed
9.
go back to reference Connolly B, O'Halpin D: Sonographic evaluation of the abdomen in Henoch-Schönlein purpura. Clinical Radiology. 1994, 49: 320-323. 10.1016/S0009-9260(05)81796-9.CrossRefPubMed Connolly B, O'Halpin D: Sonographic evaluation of the abdomen in Henoch-Schönlein purpura. Clinical Radiology. 1994, 49: 320-323. 10.1016/S0009-9260(05)81796-9.CrossRefPubMed
10.
go back to reference Roberts PF, Waller TA, Brinker TM, Riffe IZ, Sayre JW, Bratton RL: Henoch-Schonlein purpura: a review article. Southern Medical Journal. 2007, 100: 821-824.CrossRefPubMed Roberts PF, Waller TA, Brinker TM, Riffe IZ, Sayre JW, Bratton RL: Henoch-Schonlein purpura: a review article. Southern Medical Journal. 2007, 100: 821-824.CrossRefPubMed
11.
go back to reference Weiss PF, Feinstein JA, Luan X, Burnham JM, Feudtner C: Effects of corticosteroid on Henoch-Schönlein purpura: a systematic review. Pediatrics. 2007, 120: 1079-1087. 10.1542/peds.2007-0667.CrossRefPubMedPubMedCentral Weiss PF, Feinstein JA, Luan X, Burnham JM, Feudtner C: Effects of corticosteroid on Henoch-Schönlein purpura: a systematic review. Pediatrics. 2007, 120: 1079-1087. 10.1542/peds.2007-0667.CrossRefPubMedPubMedCentral
12.
go back to reference Jeong YK, Ha HK, Yoon CH, Gong G, Kim PN, Lee MG, Min YI, Auh YH: Gastrointestinal involvement in Henoch-Schönlein syndrome: CT findings. AJR American Journal of Roentgenology. 1997, 168: 965-968.CrossRefPubMed Jeong YK, Ha HK, Yoon CH, Gong G, Kim PN, Lee MG, Min YI, Auh YH: Gastrointestinal involvement in Henoch-Schönlein syndrome: CT findings. AJR American Journal of Roentgenology. 1997, 168: 965-968.CrossRefPubMed
13.
go back to reference Sandell J, Ramanan R, Shah D: Penile involvement in Henoch-Schönlein purpura. Indian Journal of Pediatrics. 2002, 69: 529-530. 10.1007/BF02722659.CrossRefPubMed Sandell J, Ramanan R, Shah D: Penile involvement in Henoch-Schönlein purpura. Indian Journal of Pediatrics. 2002, 69: 529-530. 10.1007/BF02722659.CrossRefPubMed
14.
go back to reference Pennesi M, Biasotto E, Saccari A: Schönlein-Henoch purpura involving the penis. Archives of Disease in Childhood. 2006, 91: 603-10.1136/adc.2005.072652.CrossRefPubMedPubMedCentral Pennesi M, Biasotto E, Saccari A: Schönlein-Henoch purpura involving the penis. Archives of Disease in Childhood. 2006, 91: 603-10.1136/adc.2005.072652.CrossRefPubMedPubMedCentral
15.
go back to reference Fischer G, Rogers M: Vulvar disease in children: a clinical audit of 130 cases. Pediatric Dermatology. 2000, 17: 1-6. 10.1046/j.1525-1470.2000.01701.x.CrossRefPubMed Fischer G, Rogers M: Vulvar disease in children: a clinical audit of 130 cases. Pediatric Dermatology. 2000, 17: 1-6. 10.1046/j.1525-1470.2000.01701.x.CrossRefPubMed
Metadata
Title
Abdominal wall and labial edema presenting in a girl with Henoch-Schönlein purpura: a case report
Authors
Rania Hiram-Karasmanis
Ronald Garth Smith
Maria Radina
Donald Allen Soboleski
Publication date
01-12-2010
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2010
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/1752-1947-4-98

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