A Case of Henoch-Schonlein Purpura Complicated by Hemorrhagic Ascites / 대한류마티스학회지

ABSTRACT

Henoch-Schonlein purpura (HSP) is a systemic vasculitis with IgA dominant immune complex deposits affecting small vessels in the skin, joint, gastrointestinal tract, and kidneys. Gastrointestinal symptoms are common and may precede the appearance of characteristic skin rash. These manifestations include abdominal pain, bleeding, bowel infarction, intussusception, or even, perforation. However, hemorrhagic ascites has been rarely described in patients with HSP. The pathophysiologic mechanism is presumably a vasculitis of the small vessels within the serosa. We report a 37-year-old man with HSP complicated by hemorrhagic ascites. Contrast CT of the abdomen showed extensive bowel wall thickening and ascites. A paracentesis yielded hemorrhagic fluid. These abdominal manifestations were improved after methylprednisolone pulse therapy.