[Broken External Image]:http://dermimages.med.jhmi.edu/images/henoch_schonlein_purpura_10_080209.jpg Write your diagnosis below Thanks John Jossef
Related Self Assessment Questions ( Difficulty level - USMLE step 2 & 3 ) A 3-year-old child is seen in the ER with a history of a recent acute respiratory infection. The mother reports that the child has been complaining of bilateral knee pain and abdominal discomfort. On examination, you notice a palpable purpuric rash on the buttocks extending to both lower extremities. What is the most likely diagnosis? A. immune thrombocytopenic purpura (ITP) B. Henoch-Schönlein purpura (HSP) C. Evans syndrome D. meningococcemia E. hemolytic uremic syndrome (HUS) EXPLANATION: HSP is also commonly referred to as anaphyllactoid purpura. HSP is a small vessel vasculitis. The rash of HSP is very characteristic and is commonly located on the lower extremities and buttocks. Abdominal pain, joint pain, and nephritis are common features of the disease as well. These complaints are usually self-limiting. Symptomatic treatment including hydration and pain control with acetaminophen may be given. Avoidance of competitive activities and elevation of the lower extremities may help reduce any local edema. The answer is B. A 3-year-old child is seen in the ER with a history of a recent acute respiratory infection. The mother reports that the child has been complaining of bilateral knee pain and abdominal discomfort. On examination, you notice a palpable purpuric rash on the buttocks extending to both lower extremities. Treatment of Henoch-Schönlein purpura (HSP) should include which of the following? A. course of antibiotics B. no specific treatment is required at this time C. blood transfusion D. corticosteroids E. intravenous immunoglobulin (IVIG) EXPLANATION: HSP is also commonly referred to as anaphyllactoid purpura. HSP is a small vessel vasculitis. The rash of HSP is very characteristic and is commonly located on the lower extremities and buttocks. Abdominal pain, joint pain, and nephritis are common features of the disease as well. These complaints are usually self-limiting. Symptomatic treatment including hydration and pain control with acetaminophen may be given. Avoidance of competitive activities and elevation of the lower extremities may help reduce any local edema. The answer is B.
