Uncommon multisystemic involvement in a case of Henoch-Schönlein purpura

A case of Henoch-Schönlein purpura (HSP) characterized by several unusual complications is reported. A 10-year-old boy was hospitalized with acute abdomen and developed purpura on the lower extremities after 4 days of hospitalization. He had protein-losing enteropathy, diagnosed by an elevated fecal alpha-1-antitrypsin clearance. The colicky abdominal pain and protein-losing enteropathy subsided after methylprednisolone pulse therapy was administered. He had left hydronephrosis and gall-bladder abnormalities detected by ultrasonography, and purpura nephritis. However, after improvement of these abnormalities, he showed steroid-induced epidural lipomatosis, detected by magnetic resonance imaging, which resolved with steroid reduction. Ultrasonography and magnetic resonance imaging were useful for detecting these uncommon multisystemic involvements in HSP.