Henoch-Schönlein Purpura Presenting with Acute Abdomen

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Henoch-Schönlein Purpura (HSP) is an autoimmune, systemic, non-granulomatous vasculitis characterised by self-limiting clinical course, and leukocytoclastic vasculitis of small vessels. Deposition of immune complexes that contain IgA is the hallmark of vascular involvement. Adults with HSP have a higher incidence of complications and death. The most common gastrointestinal (GI) symptom of HSP is abdominal pain. Vasculitis-related colitis, causing extensive lower GI hemorrhage, is uncommon in the course of HSP, which increases the risk of renal involvement. Here, we present two cases of HSP with GI involvement. In the first case, surgery was performed. Whereas, the other patient was treated medically due to the experience gained from the first case. The HSP has no specific treatment. Most of the cases are mild and need only supportive care due to its self-limiting nature. Although corticosteroids do not prevent recurrences, evidence in literature suggests that these are beneficial in resolution of the arthritis and abdominal pain. Aggressive therapy with corticosteroids or cyclophosphamide is not successful in reducing renal damage, except in patients with crescentic nephritis. Key Words: Henoch-Schönlein purpura, Gastrointestinal complications, Steroids, Surgery.