CLINICAL & RADIOLOGICAL CORRELATION OF GASTROINTESTINAL (GI) MANIFESTATIONS IN HENOCH-SCHOENLEIN SYNDROME (HSS)

Abstract

20 children, aged 3-10 yr., had severe colicky abdominal pains with HSS. 9 children also had joint pains. Severe vomiting (3) or hematemesis (3) lead to blood electrolytes imbalance. Occult blood in stools was present in 15, of whom 4 had melena and 2 had fresh blood in stools. 10 children showed some renal involvement. 6 children had B-strep cultured from throat swab, while 4 had elevated ASO titre. Normal S. complement was present in 11 children studied.

Of the x-ray studies in 19 children, 15 had Barium studies. The results were divided into 3 groups - a) Presence of ileus in 4, b) Intestinal mucosal edema in 3, c) Evidence of submucosal/intramural hemorrhage in bowel wall in 12 children. 8 of 12 in group (c) had intramural hemorrhage limited to upper small bowel wall. 4 had either distal ileum or entire small bowel involvement. Hemorrhage in the ureteral wall was noted in 1. The transit time of Barium was delayed in all studies. Abnormal studies returned to normal in a month. Correlation between GI symptoms and x-ray changes in the small bowel was good.

11 children were treated with Prednisone. Of 2 children with intussusception, 1 had a surgical reduction. 3 of 10 children with renal involvement and severe GI symptoms and x-ray changes progressed to proliferative nephritis with nephrotic syndrome.

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