Abstract: Objective　To summarize the clinical features of Henoch-Sch?nlein purpura (HSP) with terminal ileitis. Method The clinical data of HSP complicated with terminal ileitis confirmed by pathological biopsy in a child was retrospectively analyzed, and the related literature was reviewed. Results　A 5-year-old boy was admitted to hospital due to abdominal pain and rash on both lower extremities. Ultrasonography and abdominal CT showed partial intestinal wall thickening. Endoscopy revealed patchy hemorrhage and scattered ulcers in the terminal ileum, suggesting terminal ileitis and excluding inflammatory bowel disease. Emergency laparotomy was performed for acute abdomen on the fifth day after enteroscopy, and end ileum perforation was observed during the operation. Finally, endoscopic biopsy revealed IgA deposition. Because of the microscopic hematuria and proteinuria during the course of disease in addition of the rash, the child was diagnosed with HSP combined with terminal ileitis. Thirteen identical cases were retrieved, and when including 1 case in this study, a total of 14 cases were found. Among them, 9 children were older than 18 years, 9 had abnormal urine tests (microscopic hematuria and/or proteinuria) and 6 had undergone surgery. Conclusion　HSP complicated with terminal ileitis is rare and easy to be confused with Crohn disease. If there is clinical doubt, pathological biopsy should be conducted as soon as possible to make a definite diagnosis.

Key words: Henoch-Sch?nlein purpura;　terminal ileitis;　Crohn disease;　abdominal pain