Corticosteroid Treatment for Recurrent Henoch- Schönlein Purpura with Gastrointestinal Manifestation: A Case Report

Abstract

Aims: Henoch-Schönlein Purpura (HSP) is the most common vasculitis during childhood yet sometimes is misdiagnosed. Gastrointestinal symptom in HSP is a frequent finding which causes patient to seek medical care. Recurrent episode of HSP occurs in 2.7–30% cases, most of which has predisposing factors. HSP is usually a self-limiting disease which is managed with supportive treatment. Limited evidence has been reported about the use of corticosteroid for HSP. Presentation of Case: A 10-year-old girl came with chief complaints of abdominal pain, nausea and vomiting, and palpable purpura in lower extremities a day prior to admission, preceded by upper respiratory tract infection. Patient had history of similar symptoms before, she was diagnosed with recurrent HSP with skin and gastrointestinal manifestations. She was treated with corticosteroid for two weeks and showed clinical improvement during follow-up. Discussion: Recurrent episode of HSP occurs more frequently in patients with predisposing factors. Although there is no specific recommendation about the use of corticosteroid for HSP, several studies reported benefits of corticosteroid for patients with organ involvement such as gastrointestinal to relieve the pain. We considered giving short-term corticosteroid and observed clinical improvement in our patient. Conclusion: Identifying predisposing factors for HSP in each patient may help to prevent the recurrence. Despite limited evidence regarding the use of corticosteroid, short-term use of corticosteroid could be considered in HSP with gastrointestinal involvements to relieve the symptoms.