• WangShuoSThe First People's Hospital of Changde City, Changde, Hunan, China., Hongyan Tang, Wei Du, and Yiyi Ding.
• The First People's Hospital of Changde City, Changde, Hunan, China.
• Medicine (Baltimore). 2021 Dec 17; 100 (50): e28240e28240.

RationaleHenoch-Schoenlein purpura (HSP) is a systemic small-vessel vasculitis that commonly occurs in children. Gastrointestinal HSP can rarely progress to gastrointestinal perforation, followed by massive gastrointestinal bleeding.Patient ConcernsAn 8-year-old Chinese boy was transferred to the pediatric intensive care unit of our hospital with an emergency occurrence of purpura, severe hematemesis, large bloody stools, and sharp abdominal pain, and complained of abdominal pain and rash 2 weeks prior.DiagnosisThe patient had purpura with lower limb predominance, abdominal pain, and gastrointestinal bleeding. Immunofluorescence microscopy of histological sections showed granular and lumpy IgA focal deposition in the blood vessel walls. He was diagnosed with HSP.InterventionsInitially, he was treated with methylprednisolone, posterior pituitary injection, somatostatin, and hemocoagulase, together with the infusion of large blood products. Postoperatively, he was administered nasal continuous positive airway pressure -assisted ventilation, anti-infection treatment, albumin transfusion, platelet transfusion, abdominal drainage, methylprednisolone, fluconazole anti-fungal treatment, and wound dressing.OutcomesThere was no evidence of rebleeding, abdominal pain, or purpura at the 2-month follow-up assessment.LessonsAbdominal HSP should be alert to gastrointestinal perforation when using hormone therapy.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

18 keywords...

hide…