Intravenous immunoglobulins in Henoch-Schönlein purpura with severe gastrointestinal involvement. Case report and review of the literature

Henoch-Schönlein purpura (HSP) is the most common systemic vasculitis in children. It often follows a viral infection. Although it is a self-limiting disease, various acute, and chronic complications can occur. We describe a case of a 6-year-old boy presenting with HSP and secondary multi-organ involvement. Because of diffuse purpura and arthralgia associated with acute abdominal pain, oral corticosteroid was administered but with no clinical improvement. Despite steroid treatment, the child developed hematemesis and massive intestinal hemorrhage, so he was treated with one dose of intravenous immunoglobulin (IVIG). This produced significant improvement in the gastrointestinal, cutaneous, and articular symptoms. Our case report demonstrates that IVIG may be useful in the treatment of complicated HSP with gastrointestinal involvement, but more structured research and guidelines are necessary for a correct therapeutic approach.