Quiz: How would you manage this child’s purpuric lesions?
This three-year-old girl presents to her paediatrician with a one-week history of abdominal pain and a rash.
Her mother mentions that the rash developed following recovery from a URTI and that she has also been complaining of knee pain.
On examination, a purpuric rash is seen on her legs and feet. Urinalysis reveals haematuria and proteinuria.
Which of the following is most likely to be associated with this patient’s condition?
- Hearing loss
- Coronary artery dilation
You can check your answer under the image.
This patient’s findings are suggestive of Henoch-Schönlein purpura (HSP): the most common paediatric vasculitis, involving the small vessels of the skin, gastrointestinal tract, kidneys and joints.
The self-limiting condition is characterised by the classic clinical triad of purpura, abdominal pain and arthritis.
Intussusception is a complication of the condition and the most common surgical indication, occurring in approximately 3% of HSP patients.
Acute or progressive abdominal findings should signal clinicians to investigate accordingly.
You can see more cases like this at Figure1.