Recurrent Abdominal Pain with A Late Clue: Diagnosing Henoch-Schonlein Purpura After Skin and Joint Involvement
I Gusti Agung Ayu Sriningrat1*, Calista Dinda Natania Rau1, Ni Nyoman Wulan Yuanitasari1, Sulistio Ivena Clairine1, Putu Pradnyanita Mustika2
Abstract
Background: Henoch-Schonlein purpura (HSP) is the most common childhood vasculitis, primarily affecting children under 10 years. While typically self-limiting with a good prognosis, HSP can become life-threatening if multiple organs are involved. Early diagnosis was critical to prevent complications and ensure optimal outcomes. Objective: To highlight the diagnostic challenges of HSP when recurrent abdominal pain appeared with delayed onset of purpura and athralgia. Case: A 10-year-old male presented with abdominal pain, had been hospitalized, but after discharge, he developed red spots on his lower extremities and buttocks along with joint pain in his legs. As his abdominal pain recurred and worsened, he was readmitted. Physical examination revealed diffuse tenderness and palpable purpura on the lower extremities and gluteal area. Investigations revealed leukocytosis, neutrophilia, a high neutrophils/lymphocytes ratio, high Erythrocyte Sedimentation Rate, proteinuria, and a positive occult blood test. Inpatient therapy consisted of intravenous corticosteroids, intravenous Histamin-2 (H2) blockers, and oral nonsteroidal anti-inflammatory drugs. Upon discharge, all therapy was administered orally, with corticosteroids gradually tapered over 14 days. The patient showed clinical improvement without complications. Conclusion: HSP should be considered in the differential diagnosis of recurrent abdominal pain, even when of purpura and joint symptoms are absent initially. Early recognition can prevent diagnostic delays and reduce the risk of serious complications.
Keywords
henoch-schonlein purpura; abdominal pain; vasculitis; pediatric; delayed diagnosis
Cite This Article
Sriningrat, I. G. A. A., Rau, C. D. N., Yuanitasari, N. N. W., Clairine, S. I., Mustika, P. P. (2025). Recurrent Abdominal Pain with A Late Clue: Diagnosing Henoch-Schonlein Purpura After Skin and Joint Involvement. International Journal of Scientific Advances (IJSCIA), Volume 6| Issue 6: Nov – Dec 2025, Pages 1112-1117 URL: https://www.ijscia.com/wp-content/uploads/2025/11/Volume6-Issue6-Nov-Dec-No.982-1112-1117.pdf
Volume 6 | Issue 6: Nov – Dec 2025
