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Gallbladder involvement of Henoch-Schönlein purpura mimicking acute acalculous cholecystitis
Jörg C Hoffmann1, Philipp Cremer, Jan C Preiss
1Medizinische Klinik I mit Schwerpunkt Gastroenterologie/Infektiologie/Rheumatologie, Charité, Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Deutschland. joerg.hoffmann@charite.de
Background/Aims:
We report the case of a 53-year-old man with fever and severe abdominal pain following an upper respiratory tract infection.
Methods/Results:
The clinical signs, the laboratory markers, and the ultrasound findings were consistent with acute acalculous cholecystitis and he underwent cholecystectomy. Histologically the gallbladder showed vasculitis and the patient developed postoperatively a purpuric rash of the legs with transient ankle arthritis. Gastroscopy revealed prepyloric ulcers consistent with vasculitis. The patient was diagnosed as having Henoch-Schönlein purpura. Gastric ulcers as well as arthritis disappeared upon treatment with corticosteroids and proton pump inhibitors.
Conclusion:
Taken together, Henoch-Schönlein purpura can mimic acute cholecystitis and should be considered as a rare differential diagnosis of acute cholecystitis.
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