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DDx

Discussion in 'Spot Diagnosis' started by J.P.C. Peper, Aug 29, 2012.

  1. J.P.C. Peper

    J.P.C. Peper Bronze Member

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    What's your diagnosis?

    The patient is a young man. It's not an infection.

    I'll post the correct answer in a few days!

    DDx.jpg
     

    Add Reply

  2. gizem_A

    gizem_A Famous Member

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    Henoch Schönlein purpura
     


  3. Emergency medicine Mike

    Emergency medicine Mike Bronze Member

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    Dermal exantema with petechial haemoragia called henoch schonlein purpura.
     


  4. Gospodin Seki

    Gospodin Seki Moderator Staff Member

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    Henoch Schonlein purpura
     


  5. Pubudu_weerawardana

    Pubudu_weerawardana Famous Member

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    Henoch Schonlein purpura
     


  6. sundarto

    sundarto Bronze Member

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    if the thrombocyte count is normal or slightly increase (non thrombocytopenic), then it is a Henoch schonlein purpura, otherwise it could also be ITP or a DIC case
     


  7. J.P.C. Peper

    J.P.C. Peper Bronze Member

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    Correct answer:

    Henoch-Schönlein purpura.

    This is a small vessel vasculitis, which presents with purpura often over the buttocks and extensor surfaces, typically affecting young men. There may be glomerulonephritis, joint involvement, and abdominal pain (which may mimic an acute abdomen).
     


  8. neo_star

    neo_star Moderator

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    Related Self Assessment Questions

    A 7-year-old boy has cramping abdominal pain and a rash mainly on the back of his legs and buttocks as well as on the extensor surfaces of his forearms. Laboratory analysis reveals proteinuria and microhematuria. You diagnose Henoch-Schönlein, or anaphylactoid, purpura. In addition to his rash and abdominal pain, what other finding is he likely to have?

    A. Chronic renal failure
    B. Arthritis or arthralgia
    C. Seizures
    D. Unilateral lymphadenopathy
    E. Bulbar nonpurulent conjunctivitis

    EXPLANATION:

    Henoch-Schönlein purpura (HSP), or anaphylactoid purpura, is a systemic IgA-mediated vasculitis. The rash of anaphylactoid purpura most often involves extensor surfaces of the extremities; the face, soles, palms, and trunk are less often affected. Other significant symptoms include edema, arthralgia or arthritis, colicky abdominal pain with GI bleeding, acute scrotal pain, and renal abnormalities ranging from microscopic hematuria to acute renal failure. As HSP is a systemic vasculitis, any organ system can be affected. The prognosis, however, is excellent, with only a small percentage of children going on to end-stage renal failure. Seizures are an uncommon complication of CNS involvement; more commonly, patients will complain of headache and will have behavioral changes.

    Unilateral lymphadenopathy and nonpurulent conjunctivitis are not typical of HSP (but are criteria for Kawasaki disease, another pediatric vasculitis).

    The answer is B.
     

    Last edited: Jan 28, 2013

  9. Hasan

    Hasan Bronze Member

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    hsp
    itp
    dic
     


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