Which GI findings are characteristic of Henoch-Schönlein purpura (IgA vasculitis)?

Updated: Jan 08, 2021
  • Author: Rajendra Bhimma, MBChB, MD, PhD, DCH (SA), FCP(Paeds)(SA), MMed(Natal); Chief Editor: Craig B Langman, MD  more...
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Answer

Abdominal pain and bloody diarrhea may precede the typical purpuric rash of IgAV, complicating the initial diagnosis and even resulting in unnecessary laparotomy. GI manifestations occur in about 50% of cases and usually consist of colicky abdominal pain, melena, or bloody diarrhea. Hematemesis occurs less frequently. Intussusception should be suspected in IgAV patients with abdominal pain or melena. Barium enema is frequently therapeutic.

The duodenum and small intestine are the most frequently involved segments of the GI tract. Duodenal ulcers also occur. Massive GI bleeding has been reported in IgAV. [83] Ileal vasculitis has also been reported.


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