A case of Henoch-Schönlein purpura presenting with massive lower gastrointestinal bleeding

Abstract

Gastrointestinal involvement is common in Henoch-Schönlein purpura, whereas life-threatening gastrointestinal bleeding is very rare. A seven-year-old male patient who was diagnosed with Henoch-Schönlein purpura four days before admitted with rectal bleeding and impaired general well-being. Palpable purpuric rash on the lower extremities and a clinical picture of shock were observed during the physical examination. His first hemoglobin value was 17 g/dl. Intravenous fluid, erythrocyte suspension and methylprednisolone were administered. The patient's condition improved and he was discharged to continue follow-up as an outpatient. In the case of gastrointestinal system involvement, early administration of steroid therapy reduces the risk of complications and improves the clinical outcome. It is important to bear in mind that in the early stages of massive bleeding, fluid loss may be more evident than blood loss, so hemoconcentration may be observed; hence, vital findings deserve more attention than laboratory results.