Henoch Schonlein Purpura Presenting with Intussusception in a 7-Year-Old Female in South-West Nigeria: A Case Report

Henoch-Schonlein Purpura (HSP) is the most common childhood systemic vasculitis. It is characterized by leucocytoclastic vasculitis and IgA deposition in the skin, joints, gastrointestinal tract, and kidneys, and typically manifests with purpura, arthritis/arthralgia, abdominal pain and nephritis. About 70% of children with HSP develop abdominal pain from submucosal haemorrhage and bowel wall oedema. These may result in gastrointestinal complications such as intussusception and may impact adversely on outcome. We report a case of HSP in a 7-year-old female who had presented with a recurring course of palpable purpura restricted to both lower limbs, painful swelling of the right knee joint, as well as severe abdominal pains which later became associated with passage of bloody stools. She subsequently had an exploratory laparotomy for sonographically confirmed intussusception following which she was referred to the haematology clinic on account of persistence of purpuric limb lesions post-surgery. This report highlights HSP as the commonest childhood systemic vasculitis. Its prognosis in childhood is generally excellent, with a self-limited course in most cases. Gastrointestinal complications such as intussusception, may, however, impact adversely on outcomes, while renal involvement may progress to chronic kidney disease.