[Schoenlein-Henoch syndrome and salmonella infection: a new association?]

Schoenlein-Henoch's disease has a immunological pathogenesis (mediated by immunocomplexes), is characterised by a number of differently associated signs and symptoms, and leads to the possible involvement of the cutis, joints, abdomen and kidneys. Two cases of Schoenlein-Henoch's disease associated with acute salmonella enterocolitis were recently brought to our attention. In two girls, aged 2 years and 8 months and 13 months respectively, the onset of diarrheic alvus was followed, after an interval of 4-5 days, by the sudden appearance of pompho-erythemato-hemorrhagic and petechial cutaneous lesions localised symmetrically on the extensor surfaces of the lower limbs and buttocks, and accompanied in the first case by intense abdominal pain and in the second by diffuse arthralgia, with predominant involvement of the tibio-tarsal joints. Laboratory tests showed slight alterations of phlogosis indexes and high levels of serum IgA (182 and 204 mg/dl respectively). The examination of feces showed the presence of occult blood and salmonella (belonging to C and D groups respectively) were isolated in the coproculture. Other culture and serological tests carried out while in hospital were negative. The clinical manifestations gradually resolved within the space of two weeks following the normalisation of the alvus obtained after a few days using dietary regulation. After two months the girls were found negative on clinical examination; in the second case described there was a positive response to Widal's reaction with high antibody titres against both O and H antigens, whereas the coproculture continued to be positive for Salmonella.(ABSTRACT TRUNCATED AT 250 WORDS)