A 5 year old child presents with perivascular IgA deposition and neutrophilic collection. There is erythematous rash on the lower limb and nonblanching purpura. Probable diagnosis is
Correct Answer: Henoch-Schonlein purpura
Description: Henoch schonlein purpura : It is one of the most common vasculitic disorder of childhood. Characterised by the presence of nonthrombocytopenic , palpable purpura, transient ahralgia and abdominal symptoms. The illness begins with a rash more prominent over the extensor aspects of lower extremities and buttocks. It may be macular, maculopapular or even uicarial to begin with . Glomerulonephritis seen in one third of cases. Gastrointestinal manifestations usually occur in first 7-10 days if illness. Abdominal pain is intermittent, colicky and periumbilical.vomitingseen , whereas melena and hemetemesis are less common. Rare manifestations include CNS vasculitis, coma, Guillain Barre syndrome, pulmonary hemorrhage, carditis and orchitis. Criteria for childhood HSP:- Palpable purpura in the presence of at least one of the following 4 features: 1. Diffuse abdominal pain. 2. Any deposit showing IgA deposition. 3. Ahritis/Ahralgia. 4. Renal involvement. Investigation: Nonspecific rise in total serum IgA levels. Skin biopsy shows leukocytoclastic vasculitis. On indirect immunofluorescence there are mesangial deposits of IgA andC3 in skin and renal biopsy. Reference: GHAI essential Paediatrics
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Pediatrics
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