Stenosing ureteritis in Henoch-Schönlein purpura

We report on a boy with Henoch-Schönlein purpura in whom flank pain and gross hematuria developed during the early phase of the disease. Urologic investigations revealed hydronephrosis and ureteral stenosis. Pyeloplasty was done to relieve ureteropelvic junction obstruction. Severe hemorrhagic ureteritis and vasculitis were noted on the ureteral biopsy. Recovery was slow and residual hydronephrosis persisted. Although abdominal pain usually accompanies Henoch-Schönlein purpura, colicky flank pain associated with hematuria should alert the physician to the presence of ureteritis. Recognition and early surgical treatment of this urologic complication of Henoch-Schönlein purpura may prevent a potentially serious outcome.