A child develops non-blanching macules and papules on lower extremities, mild abdominal pain and skin biopsy showed IgA deposition. Most appropriate diagnosis is –
Correct Answer: HSP
Description: Ans. is 'b' i.e., HSP Henoch-Schonlein purpura* Henoch - Schonlein purpura is vasculitis of small vessels (capillaries, venules or arterioles) and characterized by deposition of IgA in the wall of involved vessels.* H.S. purpura is characterized by tetrad of purpura, arthritis, glomerulonephritis, and abdominal pain. Gross hematuria is seen in 20-30% of cases.* All changes result from the deposition of circulating immune complexes, containing IgA and complement on the endothelium of the blood vessels throughout the body and within the glomerular mesangial regions.* Diagnosis is confirmed by presence of palpable purpura with normal platelet count along with one or more of the following : abdominal pain, arthralgia/arthritis and mesangial deposition of IgA.* Biopsy of the kidney may be performed both to establish the diagnosis or to assess the severity of already suspected kidney disease. The main findings on kidney biopsy are increased cells and IgA deposition in the mesangium (part of the glomerulus, where blood is filtered), white blood cells, and the development of crescents.* Renal manifestations usually start at the onset or within 3 months of onset of other symptoms.
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