Minh, a 14-year-old, was admitted to Tam Anh General Hospital TP HCM with mild abdominal distension and severe pain around the navel and epigastric region. Associate Professor Dr. Vu Huy Tru, Head of Pediatrics, noted these symptoms are common in gastritis, enteritis, gastrointestinal infection, intussusception, or bowel obstruction. Doctors initiated intravenous fluid replacement, administered antibiotics, and prescribed acid-reducing medication while closely monitoring his abdominal pain, vomiting, and bloody stools.

Three days later, Minh developed a purpuric rash on both legs, a typical sign of IgA vasculitis (Henoch-Schonlein). An abdominal ultrasound revealed multiple thickened, edematous small bowel loops with some fluid. Additionally, inflamed, edematous segments of the small intestine in the left abdomen were observed, accompanied by inflamed mesenteric lymph nodes.

Doctors diagnosed Minh with Henoch-Schonlein disease, a form of systemic vasculitis resulting from immunoglobulin A (IgA) deposition in blood vessel walls. This condition affects approximately 8-20 children per 100,000 annually and can damage the skin, gastrointestinal tract, joints, and kidneys. Abdominal pain and gastrointestinal bleeding often precede the skin rash, making early diagnosis challenging as symptoms can be mistaken for enteritis or gastrointestinal infection.

Throughout his hospitalization, Minh's blood pressure, incidence of bloody stools, and abdominal pain were carefully monitored. Given his gastrointestinal bleeding, doctors prescribed fasting and maintained intravenous fluid replacement to support his recovery.

Associate Professor Tru checks the hemorrhagic spots on Minh's legs. Photo: Tam Anh General Hospital

After six days, Minh's vomiting, bloody stools, and hypertension gradually improved. He was able to consume thin porridge and was subsequently discharged. He requires follow-up appointments within one year to facilitate the early detection of any kidney abnormalities.

Associate Professor Tru stated that medical science has not yet identified the specific cause of Henoch-Schonlein disease. However, risk factors include infections, allergies, or immune reactions following vaccination. The underlying mechanism of the disease is recognized as an immune disorder.

Associate Professor Tru advises that children experiencing abdominal pain coupled with bloody stools, a purpuric rash on their limbs, or joint pain should seek early medical attention for a comprehensive evaluation and appropriate treatment.

Minh Tam