Objective: To probe into the clinical characteristics of abdominal Henoch-Schönlein purpura (HSP) complicated with protein-losing enteropathy (PLE) in children

and to compare the differences with the abdominal HSP with normal albumin. Methods: Nineteen children diagnosed with abdominal HSP complicated with PLE admitted into Chengdu Women’s and Children’s Central Hospital

School of Medicine

University of Electronic Science and Technology of China from Jan. 2015 to Feb. 2020 were extracted. Nineteen children with abdominal HSP and normal albumin who were hospitalized during the same period were selected as the control group by 1∶1 propensity score matching. Case-control study method was performed to analyze the clinical manifestations

biochemical indicators

imaging examination

endoscopic changes and pathological results of two groups. Results: There were 19 cases in the PLE group

including 10 males and 9 females

the male/female ratio was 1.1︰1.0. The average age of onset was (6.2±2.0) years. The main clinical manifestations were abdominal pain and rash

partly accompanied by hematochezia

vomiting

hypoprotein edema and joint swelling. In PLE group

significant increases were found in white blood cells

neutrophils

C-reactive protein (CRP)

platelets

neutrophils/lymphocytes (NLR)

and decreases were found in albumin and immunoglobulin G

statistically different from those in the control group (P<0.05). Imaging changes indicated intestinal wall thickening and ascites. Results of gastroscopy showed congestion and edema of gastric and duodenal mucosa

and some lesions such as erosion and ulcer. Pathological changes mainly suggested mucosal epithelial cell swelling

submucosal vasodilation

vascular wall necrosis

interstitial edema

perivascular inflammatory changes

neutrophil

lymphocyte and eosinophil infiltration. The length of stay in the PLE group were longer than that in the control group

with statistically significant difference (P<0.05). Conclusion: The clinical manifestations of abdominal HSP complicated with PLE are significantly increased inflammatory indicators such as white blood cells

neutrophils

CRP and NLR

severe intestinal mucosal injury and long length of stay. Therefore

active and effective treatment measures should be taken.