A 24 year old female presents with palpable Purpura and with rashes all over trunk limbs buttocks and paid abdomen

Question 85

A 24 year old female presents with palpable Purpura and with rashes all over trunk limbs buttocks and paid abdomen. The most probable diagnosis is

a.       Meningococceimia

b.      HSP

c.       ??

d.      ??

Answer

b. HSP

Reference

Harrison 16^th Edition Page 2010

QTDF

Harrison

Quality

Reader

Status

New

Discussion

Henoch-Schonlein purpura, also referred to as anaphylactoid purpura, is a distinct systemic vasculitis syndrome that is characterized by palpable purpura (most commonly distributed over the buttocks and lower extremities), arthralgias, gastrointestinal signs and symptoms, and glomerulonephritis. It is a small vessel vasculitis.

Henoch-Schonlein purpura is usually seen in children; most patients range in age from 4 to 7 years; however, the disease may also be seen in infants and adults. It is not a rare disease; in one series it accounted for between 5 and 24 admissions per year at a pediatric hospital. The male-to-female ratio is 1.5:1. A seasonal variation with a peak incidence in spring has been noted

Explanation

Self Explanatory

Comments TREATMENT

The prognosis of Henoch-Schonlein purpura is excellent. Most patients recover completely, and some do not require therapy. Treatment is similar for adults and children. When glucocorticoid therapy is required, prednisone in doses of 1 mg/kg per day and tapered according to clinical response has been shown to be useful in decreasing tissue edema, arthralgias, and abdominal discomfort; however, it has not proven beneficial in the treatment of skin or renal disease and does not appear to shorten the duration of active disease or lessen the chance of recurrence. Patients with rapidly progressive glomerulonephritis have been anecdotally reported to benefit from intensive plasma exchange combined with immunosuppressive drugs.

Tips :

Ä     Renal failure is the most common cause of death in the rare patient who dies of Henoch-Schonlein purpura.

Ä     Myocardial involvement can occur in adults but is rare in children.

Ä     Routine laboratory studies generally show a mild leukocytosis, a normal platelet count, and occasionally eosinophilia. Serum complement components are normal, and IgA levels are elevated in about one-half of patients.