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Published on: December 8, 2014
[A case of idiopathic recurrent duodenojejunitis]
Sung Yeol Jang1, Jung Hee Kim, Sung Hae Ha
1Department of Internal Medicine, Bundang Jesaeng General Hospital, Seongnam, Korea.
Summary
This study reports a rare case of recurrent duodenojejunitis mimicking gastrointestinal Henoch-Schönlei purpura but without the characteristic purpura. The condition responded well to prednisolone treatment, highlighting a unique diagnostic and therapeutic challenge.
Area of Science:
- Gastroenterology
- Internal Medicine
- Pathology
Background:
- Duodenojejunitis has diverse causes, including Henoch-Schönlei purpura (H-S purpura), vasculitis, and infections.
- Gastrointestinal involvement in H-S purpura typically presents with abdominal pain, but the absence of characteristic purpura can complicate diagnosis.
Observation:
- A 31-year-old male presented with recurrent left upper quadrant pain, endoscopic findings of duodenal and jejunal erythema, and hemorrhagic erosions.
- The patient lacked typical H-S purpura symptoms like skin lesions, joint pain, or hematuria, and initial autoimmune and vascular workups were negative.
- Despite recurrent episodes over 8 years, abdominal imaging revealed no significant abnormalities.
Findings:
- The patient's symptoms and endoscopic lesions improved with oral prednisolone, suggesting an inflammatory etiology.
- Recurrent duodenojejunitis occurred 16 times, consistently treated with prednisolone, with no extra-intestinal manifestations observed.
Implications:
- This case highlights a rare presentation of primary recurrent duodenojejunitis mimicking H-S purpura gastrointestinal involvement without systemic signs.
- The successful treatment with prednisolone suggests a potential role for corticosteroids in managing such idiopathic cases.
- Further research may be needed to elucidate the specific pathophysiology of this H-S purpura-like condition without purpura.
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