Open Access Highly Accessed Case report

Abdominal wall and labial edema presenting in a girl with Henoch-Schönlein purpura: a case report

Rania Hiram-Karasmanis1, Ronald Garth Smith1*, Maria Radina2 and Donald Allen Soboleski3

Author Affiliations

1 Department of Pediatrics, Queen's University, Kingston, ON, Canada

2 Faculty of Health Sciences, Queen's University, Kingston, ON, Canada

3 Department of Diagnostic Radiology, Kingston General Hospital, Kingston, ON, Canada

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Journal of Medical Case Reports 2010, 4:98  doi:10.1186/1752-1947-4-98

Published: 29 March 2010

Abstract

Introduction

Henoch-Schönlein purpura is a common immunoglobulin A-mediated vasculitic syndrome in children, characterized by purpuric rash, arthritis and abdominal pain. Renal involvement, manifested by the presence of hematuria and/or proteinuria, is also frequently seen. In most cases, patients with this disease achieve complete recovery, but some progress to renal impairment. Gastro-intestinal manifestations are present in two-thirds of affected patients and range from vomiting, diarrhea, and peri-umbilical pain to serious complications such as intussusception and gastrointestinal hemorrhage.

Case presentation

We report the case of a 7-year-old Caucasian girl who presented with abdominal pain, labial swelling, and a large abdominal ecchymosis two weeks after having been diagnosed with Henoch-Schönlein purpura. A computed tomography scan revealed abdominal wall edema extending to the groin, without any intra-abdominal pathology. She was successfully treated with intravenous steroids.

Conclusion

Circumferential anterior abdominal wall edema and labial edema have never been reported previously, to the best of our knowledge, as a complication of Henoch-Schönlein purpura. These findings further contribute to the wide spectrum of manifestations of this disorder in the literature, aiding in its recognition and management.