Gastrointestinal Tract Injury and Clinical Characteristics in 172 Children with Henoch-Schonlein Purpura Checked by Gastroscope

Research Article

Austin J Gastroenterol. 2018; 5(1): 1094.

Gastrointestinal Tract Injury and Clinical Characteristics in 172 Children with Henoch-Schonlein Purpura Checked by Gastroscope

Zeng H*, Wang J and Li H

¹Department of Pediatric Allergy, Guangzhou Medical University, China

²Department of Pediatric Immunoloy, Guangzhou Medical University, China

³Department of Pediatric Rheumatology, Guangzhou Medical University, China

*Corresponding author: Zeng H, Pediatric Allergy, Guangzhou Women and Children’s Medical Center, Guangzhou Medical University, China

Received: February 18, 2018; Accepted: April 04, 2018; Published: April 25, 2018


Objective: To investigate gastroscopic features and explore the relationship between clinical characteristics and Gastrointestinal tract injury of Henoch- Schonlein puepura (HSP) in children.

Methods: 172 cases of children with HSP in our medical center were checked by gastroscope, the gastrointestinal tract injury feature was summarized. All the case were divided into two groups by gastroduodenal mucosal bleeding or not. It was compared among the total time of abdominal pain, pain remission time, hospitalization time, fasting time and kidney injury cases were analysis in two groups. Results: Gastroscopic mainly revealed gastroduodenal mucosal congestion, edema, rough, erosion, bleeding and ulcer which involved 148 cases of gastric (86.0%), 158 cases of duodenal involvement (91.9%). Mucosal erosion and bleeding occurs mainly in duodenum, mostly in the descending duodenum. Duodenal bleeding accounted for 36 cases (20.9%) in the bulb and 92 cases (53.5%) in the descendant. Only five cases (2.9%) of ulcer occurred in the duodenum, where four cases of bulbar ulcer, one case of descending ulcer. Esophageal and gastric cardia mucosal just occurred in 1 case.

Conclusion: Gastroscopic features of HSP in children are characterized by bleeding, erosion of duodenal mucosa and occasional duodenal ulcer formation, which mostly involve the antral mucosa, rarely involving the esophagus, cardia. The HSP patients with gastrointestinal symptoms should be checked by gastroscope. It is important to make a right diagnosis for pediatric HSP especially to atypical cases.

Keywords: Gastrointestinal tract injury; Henoch-Schonlein puepura; Pediatric allergy


HSP is a common IgA-mediated systemic vasculitis in children, which pathological changes are wide range of leukocytoclastic vasculitis, mainly in the capillaries, seldom involving venules and small arteries. Lesions can affect the skin, kidneys, joints, and gastrointestinal tract. Diagnosis of HSP relies on the typical rash. But it is certain difficult to diagnose some of the early stages of HSP in children with abdominal pain or gastrointestinal bleeding as the first symptom of existence [1], so prone to misdiagnosis and for the right treatment, this article aims to summarize gastroscopic feature of HSP in children and make some help for the assessment and treatment of the disease by exploring the correlation between the clinical characteristic and the degree to the injury of gastrointestinal mucosa [2,3].

Materials and Methods


172 pediatric cases with HSP hospitalized in our Pediatric Allergy, Immunology and Rheumatoloy Department in recent 9 months were explored, including male 104 cases (60.0%), female 68 cases (40.0%), whom ages are 2-12 (6.1 ± 2.3) years. 172 cases in children had abdominal pain, including 73 cases (42.4%) with rash as the first symptom, 57 cases (33.1%) with abdominal pain as the first symptom, 42 cases (24.4%) with abdominal pain and rash on the same day, 11 cases (6.4%) without rash, 6 cases (3.5%) without abdominal pain and 20 cases (11.6%) of kidney injury occurred during hospitalization. All cases were diagnosed HSP and finally cured after treatment in our department. Depending on gastroduodenal mucosal bleeding or not, 172 cases were divided into two groups o, one is severity of mucosal injury group, another is light mucosal injury group. These two groups had no significant differences (P> 0.05) in age and gender.


172 cases were checked with gastroscope Electronics (OLYMPUS PCF-Q260JI), to observe the color of mucosal membrane from gastric to descending duodenum, the mucosal congestion, edema, rough, erosions, ulcers and bleeding.

According to the results of gastroduodenal mucosal bleeding or not, the 172 cases were divided into light (no bleeding) and heavy groups (bleeding). Total time of abdominal pain (days), abdominal pain, hospitalization time (days), fasting time (days) and kidney injury cases were record.

SPSS20.0 statistical software was used to analyses .T test, Χ² test were used, P <0.05 was considered statistically significant.


There were 169 cases (98.3%) in total 172 cases were found the gastrointestinal tract injury, those cases show that gastroduodenal mucosa with varying degrees of injury. The gastroscopic feature is mainly characterized by gastroduodenal mucosal congestion, edema, rough, erosion, bleeding and ulcer. The gastroscopic characteristic performed spotted rash-like hemorrhagic mucosa (Figure 1), parts of rash integrate into the mucosal surface (Figure 2), raising on the mucosal surface (Figure 3), which can be combined superficial erosion bleeding. In severe cases, ulcers with yellow moss surface were formed (Figure 4). Distribution of 172 cases of children with gastroscopic mucosal changes shown in Table 1.