# Epigastric pain of unknown origin, esophageal and gastric involvement: a Henoch-Schönlein Purpura case report

## TL;DR

A 48-year-old man with unexplained stomach pain was diagnosed with Henoch-Schönlein Purpura, a rare vasculitis, highlighting the need for endoscopy in difficult cases.

## Contribution

This case report presents an atypical HSP case with gastrointestinal symptoms and no skin purpura, expanding diagnostic awareness.

## Key findings

- HSP can present with epigastric pain without typical skin symptoms.
- Endoscopy was crucial in diagnosing this complex case of HSP.
- Diagnosis was delayed due to normal rheumatologic and immunologic markers.

## Abstract

Henoch-Schönlein Purpura (HSP) is an acute systemic vasculitis that primarily affects the skin, gastrointestinal tract, kidneys and joints. It predominantly occurs in children but can occur at any age. We report a case of 48-year-old male patient suffering from unexplained epigastric pain alternating between relapses and remissions. The patient’s initial clinical manifestation was atypical, starting with severe epigastric pain, without cutaneous purpura, and with normal rheumatologic and immunologic markers, making diagnosis difficult. The patient was eventually diagnosed with HSP. This case highlights the importance of considering this diagnosis in patients with unexplained abdominal pain and emphasize the role of endoscopy in diagnosing complex cases.