The characteristics of video capsule endoscopy in pediatric
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Henoch–Schonlein purpura (HSP) is a systemic small-vessel vasculitis also named IgA vasculitis that commonly affects the gastrointestinal tract. HSP mainly involves the small vessels of skin, joints, gastrointestinal (GI) tract, and kidney. About 50% to 85% of the HSP patients have GI symptoms like acute abdominal pain, nausea, vomiting, hematochezia or melena, and diarrhea. Among the patients with GI symptoms, there is a rare portion of patients without skin manifestations, who may benefit from endoscopy evaluation. The video capsule endoscopy (VCE) characteristics of pediatric HSP patients are rarely reported.

Patients diagnosed with HSP and analyzed by VCE examination since 9 years are enrolled. The clinical features, laboratory findings, and the characteristics of VCE findings are studied.

There are 30 patients enrolled in this investigation from February 2010 to January 2020. The mean age of these patients is 96.9 ±35.8 months, and the most frequent finding of VCE is mucosal erosion, which account for 79.3% of the patients, and followed by mucosal erythema or petechia accounted for 69% of the patients. Regarding the disease location detected by endoscopy, jejunum is the most common involved part of the gastrointestinal tract in pediatric HSP patients. All the patients had the jejunum involved except in one patient the VCE did not pass through the pylorus. One third of the patients involved the descending portion of duodenum. No side effect is observed in this study.

VCE may be an excellent adjust tool for evaluation of the gastrointestinal tract in children with abdominal symptoms without typical purpura in suspected pediatric HSP patients. VCE appears to be superior to esophagogastroduodenoscopy in detecting small intestinal lesions of HSP and has an excellent safety profile.