A fatal case of bowel and cardiac involvement in Henoch-Schönlein purpura.

Henoch–Schönlein purpura (HSP) is a systemic small vessel vasculitis, characterized by the deposition of immune complexes, mainly polymeric IgA1 and C3, in the skin, gastrointestinal tract, joints, and kidneys w1x. Although the aetiology remains unknown, HSP is often associated with infectious agents. All ages may be affected although it is more common in children, and has a male predominance. Susceptibility to HSP may have a genetic basis. The dominant clinical features of HSP are cutaneous purpura (100%), arthritis (82%), abdominal pain (63%), gastrointestinal bleeding (33%), and nephritis (40%) w2,3x. The overall prognosis is good with a reported mortality of -1% and low morbidity w4x. The case reported here highlights the fatal outcome of an aggressive form of HSP, which had fatal gastrointestinal and cardiac involvement.