Gastrointestinal manifestation of Henoch-Schönlein purpura mimicking acute pancreatitis

Abstract

The authors describe a patient who was admitted to hospital for recurrent abdominal pain with mild amylase elevation and skin exanthema. Initially, the disease's course was assessed as mild acute pancreatitis with allergic skin reaction due to the analgesic administered. Unfortunately, the patient's complaints continued during hospitalisation and her urine amylase level was elevated, around the upper normal limits, together with leukocytosis. Morphologically, the pancreas was absolutely normal without any pathologies associated with pancreatitis. Neither did further investigation detect any pathology that would explain the condition; only gastroscopy revealed petechiae and oedema of the duodenal folds. 10 days after hospital admission new vasculitic eruptions, mostly on limbs, were observed, which led to the diagnosis of Henoch-Schönlein purpura with predominant gastrointestinal involvement. The particularities of gastrointestinal manifestations of this vasculitis in adult patients are also summarised.