ABSTRACT
Adolescent male resident of Hazara, Pakistan presented with abdominal pain, bilious vomiting, dysentery and knee pain of 10 days duration in July of 2014 to the emergency department of the Aga Khan University Hospital. Knee pain later migrated to ankle and was associated with redness and oedema. Abdominal x-ray revealed thickened bowel wall that was suggestive of enteritis. He was being treated with IV antibiotics [ceftriaxone and metronidazole], which did not help in resolving his symptoms. Overnight he started developing palpable rashes on his feet, back and abdomen, which raised the suspicion of Henoch-Schonlein purpura. There were no signs to suggest any respiratory and urinary systems involvement. He was given intravenous prednisolone after which his rashes dramatically disappeared and his ankle pain and other symptoms resolved. On follow up his lab investigations were within normal range with complete disappearance of rash and resolution of his abdominal pain, dysentery and bilious vomiting. Rarely dysentery is accompanied with palpable rashes and should raise suspicion of Henoch-Schonlein Purpura. Knowledge and understanding of this rare disease can help early diagnosis and initiate prompt treatment