Henoch-Schonlein purpura leads to functional gastrointestinal disorders

Saps, M.; Dhroove, G.; Chogle, A.

Dig Dis Sci. 2010 Dec 7; 56(6):1789-93

Abstract

BACKGROUND: Pain predominant functional gastrointestinal disorders such as irritable bowel syndrome may develop as sequelae to acute infectious gastroenteritis. Henoch-Schonlein purpura is a vaculitis that causes an inflammatory insult to the intestinal mucosa. OBJECTIVE: To assess whether patients with Henoch-Schonlein purpura are more likely to develop functional gastrointestinal disorders in long-term follow-up than controls. PATIENTS AND METHODS: Families of children diagnosed with Henoch-Schonlein purpura from 2002 to 2009 were contacted at least 6 months after an acute episode. Parents completed a validated questionnaire to diagnose functional gastrointestinal disorders according to Rome III criteria. RESULTS: Thirty-eight patients (mean 9.9 years, range 3-22 years, 19 males) and 38 controls (mean 9.5 years, range 1-24 years, 21 males) were recruited. Of the patients, 81% had abdominal pain with Henoch-Schonlein purpura presentation. Initial abdominal pain had resolved in all cases. At the time of study, 60.5% patients and 2.6% controls had abdominal pain. Children in Henoch-Schonlein purpura group were diagnosed with various functional gastrointestinal disorders: Irritable bowel syndrome in 11%, functional abdominal pain syndrome in 8%, and functional abdominal pain in 2.8%. Steroid usage was associated with higher incidence of abdominal pain (87.5%) at the time of the study as compared to no steroid usage (40.9%), p = 0.0065. CONCLUSIONS: Patients with Henoch-Schonlein purpura are at an increased risk of developing pain predominant functional gastrointestinal disorders. The presence of abdominal pain and use of steroids at presentation of Henoch-Schonlein purpura are associated with higher incidence of pain predominant functional gastrointestinal disorders.

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