[Henoch-Schönlein Purpura Presenting as Intussusception]

Area of Science:

• Pediatric Rheumatology
• Gastroenterology
• Systemic Vasculitis

Background:

• Henoch-Schönlein purpura (HSP) is a common childhood vasculitis.
• Gastrointestinal manifestations occur in 62-90% of HSP cases, often following skin purpura.
• Diagnosing HSP can be challenging when gastrointestinal symptoms precede characteristic rash.

Observation:

• A 5-year-old girl presented with diffuse abdominal distension, indicative of ileo-colic intussusception.
• The patient lacked typical HSP symptoms like purpura, arthralgia, or arthritis prior to surgical intervention.
• Intussusception was the initial presenting symptom, preceding any cutaneous or joint manifestations.

Findings:

• The case demonstrates ileo-colic intussusception as a potential initial manifestation of Henoch-Schönlein purpura.
• This presentation underscores that GI symptoms can precede the classic purpuric rash in HSP.
• The diagnosis of HSP was confirmed post-operatively in the context of intussusception.

Implications:

• Highlights the importance of considering HSP in children with intussusception, even without a rash.
• Suggests that early recognition of GI symptoms may aid in timely HSP diagnosis and management.
• Emphasizes the diverse clinical spectrum of Henoch-Schönlein purpura, particularly in its initial presentation.