-Report on Experiments and Clinical Cases-

A Case of Henoch-Schönlein Purpura with Rare Complications: Necrosis of the Small Intestine, Neurological Symptoms, and Pericardial Tamponade

Makoto Migita¹, Jun Hayakawa¹, Hideki Shima², Hiroyuki Kobayashi², Atsutaka Yamataka², Mutsumi Murakami¹, Takeshi Miyano² and Yoshitaka Fukunaga¹

¹Department of Pediatrics, Nippon Medical School
²Department of Pediatric Surgery, Juntendo University, School of Medicine

A case of Henoch-Schönlein purpura (HSP) with necrosis of the small intestine, neurological symptoms, and pericardial tamponade after frequent recurrence is described. Neurological symptoms were controlled well with steroid pulse therapy, and pericardial tamponade was treated successfully with pericardiocentesis and steroid pulse therapy. To treat necrosis of the small intestine, the necrotic tissue was excised and artificial anuses were constructed. Five months later, the small intestine was anastomosed in a curative operation. Periodic administration of coagulation factor XIII was required from the onset of symptoms until curative surgery, but the activity of this factor returned to normal levels after surgery operation. We report a case of Henoch-Schönlein purpura with extremely rare complications: necrosis of the small intestine, neurological symptoms, and pericardial tamponade.

J Nippon Med Sch 2005; 72: 383-386

Keywords
Henoch-Schönlein purpura, factor XIII, complications

Correspondence to
Makoto Migita, MD, PhD, Department of Pediatrics, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
Migita-Makoto-bmb@nms.ac.jp

Received, July 20, 2005
Accepted, September 28, 2005