Periumbilical Purpura Prior to Gastrointestinal Involvement in Henoch-Schonlein Purpura

Henoch-Schonlein purpura (HSP) is a systemic vasculitis involving the skin,joints, gastrointestinal tract, and kidneys. While HSP is traditionally considered a disease of children, it also occurs in adults. In both populations, acute gastrointestinal complications and chronic renal involvement are major predictors of mortality. While it has been previously demonstrated that truncal lesions in HSP are associated with underlying renal involvement, a significant proportion of cases with gastrointestinal involvement also have associated truncal lesions. It is unclear at this time whether or not the association of truncal involvement with visceral disease is related to an increased burden of circulating immune complexes or a more specific mechanism. We describe a report of periumbilical purpura antecedent to gastrointestinal involvement in an adult with HSP.