A 79-year-old man was admitted because of
cholecystitis that occurred about 40 days after sigmoidectomy had been performed for
colonic cancer. Though
antibiotics improved his condition, the patient had
hematochezia,
diarrhea, and left lower
abdominal pain. Colonoscopic findings showed multiple ring-like areas of redness and
petechiae in the rectosigmoid colon and marked
edema from the descending to the transverse colon. The patient then developed
purpura on the extensor surfaces of the legs and bilateral gonalgia, and exacerbation of the
hematochezia. A second colonoscopy (CS) showed multiple ring-like areas of redness and
ecchymosis throughout the colon. The patient was diagnosed with Henoch-Schönlein
purpura (HSP), and the symptoms were attenuated after the administration of
prednisolone. However,
diarrhea recurred in about a week; stool culture confirmed Clostridium difficile, and a third CS revealed pseudomembranes throughout the colon. The patient was diagnosed with
pseudomembranous colitis (PMC), and the administration of
vancomycin attenuated the symptoms. In conclusion, we have reported a rare adult case of PMC that occurred during
prednisolone treatment for HSP. The PMC may have been caused by changes in the intestinal bacterial flora after the sigmoidectomy and by the intestinal lesions of HSP, as well as by the administration of
antibiotics after the sigmoidectomy and for the treatment of
cholecystitis, and by the use of
prednisolone for the treatment of the HSP.