Zhang Yan, Huang Xinglan
Department of Gastroenterology, West China Hospital of Sichuan University, Chengdu, China.
Scand J Gastroenterol. 2008;43(9):1038-43. doi: 10.1080/00365520802101861.
To analyse the gastrointestinal manifestation of Henoch-Schonlein purpura (HSP) in adult patients, including clinical and endoscopic features.
Patients with a final diagnosis of HSP admitted from January 1995 to January 2006 were included. Their medical records, including clinical presentation, laboratory data, endoscopy and pathology reports, were reviewed retrospectively.
One-hundred-and-fifteen patients were included. Gastrointestinal symptoms occurred in 90 patients (78.2%), with abdominal pain the most common symptom. Fifty-four patients underwent gastroscopy, while 24 underwent colonoscopy. The endoscopic lesions included mucosal erythema, oedema, multiple irregular ulcers and nodular changes. In the upper GI tract, the second portion of the duodenum was the most frequently involved area and is where the most severe lesions occur. In the lower GI tract, the rectum was the most frequently involved area, but the most severe lesions were found in the terminal ileum.
HSP may present with acute abdomen without typical skin manifestations, and gastroscopy and colonoscopy can be helpful in the early diagnosis of HSP in these patients. Typical endoscopic findings include diffuse mucosal oedema, erythema, petechia or multiple irregular ulcers, especially in the second portion of the duodenum or in the terminal ileum.
分析成人过敏性紫癜（HSP）的胃肠道表现，包括临床和内镜特征。
纳入1995年1月至2006年1月期间最终诊断为HSP的患者。回顾性分析他们的病历，包括临床表现、实验室数据、内镜检查和病理报告。
共纳入115例患者。90例患者（78.2%）出现胃肠道症状，其中腹痛是最常见的症状。54例患者接受了胃镜检查，24例接受了结肠镜检查。内镜下病变包括黏膜红斑、水肿、多发不规则溃疡和结节样改变。在上消化道，十二指肠第二部是最常受累的部位，也是病变最严重的部位。在下消化道，直肠是最常受累的部位，但最严重的病变出现在回肠末端。
HSP可能表现为无典型皮肤表现的急腹症，胃镜和结肠镜检查有助于这些患者HSP的早期诊断。典型的内镜表现包括弥漫性黏膜水肿、红斑、瘀点或多发不规则溃疡，尤其是在十二指肠第二部或回肠末端。
