A Rare Complication of Henoch-Schönlein Purpura: Acute Appendicitis Treated Conservatively – A Case Report and Literature Review

Abstract

Henoch-Schönlein purpura (HSP) is the most common systemic vasculitis of childhood. It is a self-limiting disorder of unknown autoimmune origin. It affects multiple organ systems including the skin, joints, the gastrointestinal (GI) system, and the kidneys. GI symptoms include abdominal pain, nausea, vomiting, GI bleeding and intussusception. Acute appendicitis is an extremely rare complication of HSP. When it does occur, physicians seem to rush for surgical management. However, we suggest that conservative management should be the first approach to treatment, but great caution has to be paid to the small, yet possible risk of perforation of the appendix. Here, we present a case of an 8-year-old girl, who was admitted and diagnosed with HSP. On the second day of admission, the patient developed right iliac fossa pain and tenderness, as well as seven episodes of vomiting. She was diagnosed clinically with acute appendicitis which was confirmed by abdominal ultrasound. The patient was treated successfully with conservative management without any complication.