A Case of Henoch-Schonlein Purpura with Cerebellar and Gastrointestinal Bleeding / 대한소화기내시경학회지

ABSTRACT

Henoch-Schonlein purpura is a systemic leukocytoclastic vasculitis involving small vessels. The diagnostic criteria is defined as a typical skin rash of which pathologic examination shows leukocytoclastic vasculitis, accompanied by any two of these major manifestations of the disease, namely gastrointestinal tract, kidney, joint involvement. In elder patient, Henoch-Schonlein purpura shows more serious gastrointestinal tract involvement. There are some reports of brain involvement of Henoch-Schonlein purpura. A 69-year-old man was admitted to department of neurosurgery, because of loss of consciousness. Brain CT showed acute cerebellar hemorrhage with rapid resolution by conservative treatment. Diffuse purpuric eruptions on both low legs were developed after 7 days of hospitalization. He was refered to our department due to epigastric pain and bloody diarrhea. There were multiple longitudinal ulcers with hemorrhage on the stomach and the sigmoid colon of which biopsy showed leukocytoclastic vasculitis. Microscopic hematuria and proteinuria were also noted. He had a fatal course due to recurrent colonic bleeding and poor medical condition. We report an unusual case of cerebellar and gastrointestinal involvement of Henoch-Schonlein purpura in elderly patient.