Ulcerative colitis in an adult patient mimicking Henoch-Schönlein purpura: A case report.

Rationale: Ulcerative colitis (UC) is one of the chronic inflammatory diseases of the intestinal tract. UC being misdiagnosed as Henoch-Schönlein purpura (HSP) in the elderly has seldom been reported about.

Patient Concerns: A 64-year-old man was admitted to the hospital with petechiae and palpable purpura in lower limbs and abdominal pain for about 1 month.

Diagnoses: Colonoscopy demonstrated severe inflammation in the colon, mucosal congestion, and edema, and multiple hemorrhages and ulcerations, with purulent adhesions. A histopathologic examination of the colon biopsies revealed extensive infiltration of immune cells and mucosal ulcerations in the intestine. UC was diagnosed.

Interventions: The patient was treated with prednisone (1.0 mg/kg/d) with progressive dose reduction.

Outcomes: The skin lesions were healed within 4 weeks, and his abdominal pain was alleviated remarkably. He is currently under follow-up.

Lessons: As the treatment used for patients with HSP was not effective, it was advised that UC should be taken into consideration.