Severe esophagitis in a child with Henoch-Schönlein purpura presenting as protein-losing enteropathy.

A 4-year-old boy was seen for vomiting, diarrhea and peripheral edema. He had no evidence of nephrosis or liver dysfunction. Upper gastrointestinal endoscopy was performed for investigating the etiology of protein-losing enteropathy. It showed severe esophagitis and multiple ulcers in the descending duodenum. The symptoms and endoscopic mucosal abnormalities subsided after three weeks of hospitalization without specific therapy. Ten days after being discharged he was seen again with characteristic rash of Henoch-Schönlein purpura and arthritis without gastrointestinal symptoms. Biopsy of the skin rash revealed leukocytoclastic vasculitis.