Case ReportsRecurrent Gastrointestinal Henoch-Schönlein PurpuraNathan, Kumar B.S.; Gunasekaran, T. S. M.D.; Berman, James H. M.D. Author Information From the Division of Pediatric Gastroenterology (T.S.G., J.H.B.), Research Extern (K.N.), Lutheran General Children's Hospital (K.N., T.S.G., J.H.B.), Park Ridge; and the Ronald McDonald Children's Hospital (T.S.G., J.H.B.), Loyola University Medical Center, Maywood, IL. Address correspondence and reprint requests to Dr. T. S. Gunasekaran, Division of Pediatric Gastroenterology, Lutheran General Children's Hospital, 1775 Dempster Street, Park Ridge, IL 60068. Journal of Clinical Gastroenterology: July 1999 - Volume 29 - Issue 1 - p 86-89 Buy Abstract A 7-year-old boy was seen for severe abdominal pain, vomiting, and a 2.0-kg weight loss of 2 weeks duration. Stools were Hemoccult positive. Upper gastrointestinal (UGI) endoscopy showed multiple, raised red lesions in the duodenal bulb and descending duodenum. Although the patient did not have the typical cutaneous eruption, other findings such as acute onset of abdominal pain in a previously healthy boy, absence of infectious or surgical lesions, and more importantly endoscopic changes seen typically in the descending duodenum, led to the likely diagnosis of Henoch-Schönlein purpura (HSP). The patient was treated with prednisone and the duodenal lesions resolved. The diagnosis of HSP was confirmed 24 weeks after the initial symptom when he developed a palpable purpuric rash over both legs. Thirteen months following the initial symptoms and 6 months after the onset of rash, severe abdominal pain with epigastric tenderness recurred and stools were Hemoccult positive. UGI endoscopy showed multiple, raised red lesions in the descending duodenum as seen earlier. The patient was diagnosed with recurrent HSP. This presentation is atypical because of the abnormally long interval between the onset of abdominal pain and the appearance of the skin rash, and unique because of the endoscopically demonstrated recurrent gastrointestinal lesions. © 1999 Lippincott Williams & Wilkins, Inc.