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Purpura

Purpuras


Presentation

  • We present a rare case of a 4-year-old boy with newly diagnosed Henöch-Schonlein purpura (HSP) affecting the scrotum and penis. The patient presented to the emergency department with palpable purpura symmetrically distributed over the lower limbs.[ncbi.nlm.nih.gov]
  • When a patient presents with sicca symptoms, the diagnosis of SS is not difficult.[ncbi.nlm.nih.gov]
  • We present a patient who developed painful retiform purpura on the right flank shortly after TACE for treatment of hepatocellular carcinoma.[ncbi.nlm.nih.gov]
  • We describe a 3-year-old Malay boy who presented with simple febrile seizure and had no neurological deficit, however, he was found to have microangiopathic hemolytic anemia, thrombocytopenia, and elevated serum lactate dehydrogenase.[ncbi.nlm.nih.gov]
  • With treatment, including wound care, the lesions diminished, with granulation tissue present at 3 weeks (Panel E). Four months after presentation, the lesions had epithelialized (Panel F), and the patient regained full range of motion in the leg.[nejm.org]
Short Stature
  • Purpura may present in the first few days of life or may be delayed for weeks. 9 [ corrected ] Fanconi anemia, also an autosomal recessive disorder, is characterized by pancytopenia, hyperpigmentation and café au lait spots, short stature, skeletal abnormalities[aafp.org]
Failure to Thrive
  • […] bleeding Hemophilia Associated symptoms Abdominal pain, blood in stools, joint pain Henoch-Schönlein purpura Lethargy, fever, bone pain Leukemia Intermittent fever, musculoskeletal symptoms Systemic lupus erythematosus Lethargy, polyuria, polydipsia, failure[aafp.org]
Polydipsia
  • […] intra-articular bleeding Hemophilia Associated symptoms Abdominal pain, blood in stools, joint pain Henoch-Schönlein purpura Lethargy, fever, bone pain Leukemia Intermittent fever, musculoskeletal symptoms Systemic lupus erythematosus Lethargy, polyuria, polydipsia[aafp.org]
Dry Eyes
  • She had no sicca symptoms, dry eyes, or dry mouth. Combining the laboratory findings, Schirmer test, and labial gland biopsy, primary SS was confirmed. The patient was placed on a trial of hydroxychloroquine (200 mg once daily).[ncbi.nlm.nih.gov]
Eruptions
  • Purpuric eruption is a rare adverse event. To the best of our knowledge, this is the second case report of purpura induced by laser hair removal. Our patient is a 50-year-old woman of Arab origin.[ncbi.nlm.nih.gov]
  • Price 1 first reported a "punctate purpuric eruption" occurring in a patient receiving intramuscular penicillin, and noted that the eruption appeared for two days preceding the onset of urticaria, arthralgia, fever, and leukocytosis.[annals.org]
  • This is especially important in purpuric eruptions as they can be a manifestation of many types of internal diseases.[link.springer.com]
  • […] petechial hemorrhages (___cm), petechial hemorrhages (physical finding), petechiae (diagnosis), petechiae, Rash petechial, petechial rash, petechial hemorrhage, [D]Petechiae (situation), Petechia, Petechial hemorrhage, Petechial haemorrhage, Petechial eruption[fpnotebook.com]
  • The clinical picture is classically a cutaneous purpuric eruption of the legs and buttocks and infrequently the upper torso and extremities.[mdedge.com]
Palmar Erythema
  • […] tenderness, subcutaneous edema, scrotal swelling Henoch-Schönlein purpura Hemarthrosis Hemophilia Butterfly rash, pallor, arthritis, lymphadenopathy Systemic lupus erythematosus Lymphadenopathy Infection, drugs, malignancy Jaundice, spider angioma, palmar[aafp.org]
Angiomatosis
  • Diffuse dermal angiomatosis should be considered in the differential diagnosis of retiform purpura, especially in patients with atherosclerotic disease or underlying hypercoagulable states.[ncbi.nlm.nih.gov]
Polyuria
  • […] and intra-articular bleeding Hemophilia Associated symptoms Abdominal pain, blood in stools, joint pain Henoch-Schönlein purpura Lethargy, fever, bone pain Leukemia Intermittent fever, musculoskeletal symptoms Systemic lupus erythematosus Lethargy, polyuria[aafp.org]

Workup

  • Careful examination of skin including the bottom of the feet can help to direct the diagnostic workup for children with abdominal pain.[ncbi.nlm.nih.gov]
  • Based on the pathophysiology that is suspected, a differential diagnosis can be generated and an appropriate workup can be initiated.[link.springer.com]
  • A workup of her gastrointestinal tract, including a computed tomographic scan of the abdomen and endoscopy, failed to show an etiology for the abdominal pain.[mdedge.com]
Diffuse Vasculitis
  • The primary manifestations are due to diffuse vasculitis involving skin, musculoskeletal system, gastrointestinal tract, kidneys, and CNS. Neurological symptoms and signs occur in a significant proportion of cases with HSP.[academic.oup.com]
Hepatocellular Carcinoma
  • We present a patient who developed painful retiform purpura on the right flank shortly after TACE for treatment of hepatocellular carcinoma.[ncbi.nlm.nih.gov]
  • Cancers were hepatocellular carcinoma, duodenal cancer, and gastric cancer. Table 1 Comparison of demographical data and predisposing factors of HSP in adults and children Clinical and laboratory features Purpura was present in all patients.[ncbi.nlm.nih.gov]

Treatment

  • However, significant differences were detected for DAO and D-lactate after treatment in comparison to before treatment in the Montmorillonite experimental group (P .05).[ncbi.nlm.nih.gov]
  • The treatment of refractory immune-mediated thrombocytopenia purpura (ITP) can be challenging. This case report describes treatment of refractory ITP with bortezomib, a proteasome inhibitor.[ncbi.nlm.nih.gov]
  • After treatment with glucocorticoids, his symptoms resolved completely. Vancomycin is an extremely commonly used antibiotic with certain well-known adverse effects.[ncbi.nlm.nih.gov]
  • Prophylactic measures and attempted treatments to reduce likelihood of long-term injury are also reviewed.[ncbi.nlm.nih.gov]
  • Romiplostim is a thrombopoietin receptor agonist approved for the treatment of immune thrombocytopenia purpura.[ncbi.nlm.nih.gov]

Prognosis

  • Click here for example image of HSP Links: aetiology pathogenesis clinical features treatment and prognosis complications urticaria[gpnotebook.co.uk]
  • Prognosis Gastrointestinal or pulmonary bleeding can be life-threatening. The long term prognosis depends on the extent of the renal involvement.[orpha.net]
  • HSP has an excellent prognosis, usually resolving within one month when not complicated by significant renal disease.[amboss.com]

Etiology

  • The course varies according to the etiology, as do the diagnostic approach and treatment. This review discusses pigmented purpuras and some cutaneous vascular occlusion syndromes.[ncbi.nlm.nih.gov]
  • Its etiology and pathogenesis remain unknown. In recent years, numerous studies have pointed to a dysfunction of T cells in the pathogenesis of HSP.[ncbi.nlm.nih.gov]
  • Etiology SHP is associated with deposition of IgA-dominant immune complexes in arterioles, capillaries, and venules, but the exact etiology remains unknown.[orpha.net]
  • In the current report, the author presents the clinical features of 100 children with HSP and reviews the literature, placing particular emphasis on new information concerning the etiology, immunopathogenesis, and treatment of HSP.[ncbi.nlm.nih.gov]

Epidemiology

  • Here, we will review the epidemiology, clinical and molecular characteristics of HSP, as well as abnormalities of Th cell subsets in this disorder.[ncbi.nlm.nih.gov]
  • Summary Epidemiology SHP usually affects children and is rare in adults. Annual incidence in children is estimated at between 1/6,660 and 1/4,880, whereas it is estimated at around 1/1,000,000 in adults. The male-to-female ratio is 1.5:1.[orpha.net]
  • Epidemiology Sex: More common in children 90% of cases 10 years old Peak incidence : 6 years References: [1] [2] Epidemiological data refers to the US, unless otherwise specified.[amboss.com]
Sex distribution
Age distribution

Pathophysiology

  • Each of these morphologies is associated with a specific underlying pathophysiology.[link.springer.com]
  • ., yellow fever, cholera ) References: [3] Pathophysiology Hypothesized pathophysiological mechanism: exposure to allergen /antigen (e.g., infection, drugs) stimulation of IgA production deposition of IgA immune complexes in vascular walls (e.g., in the[amboss.com]
  • Pathophysiology The pathophysiology of Henoch-Schonlein purpura is not fully understood; however, IgA plays a significant role.[ncbi.nlm.nih.gov]
  • ALL) Acute myeloid leukemia (AML) Background Epidemiology Incidence (Audemard-Verger, 2015) Children – 3-26/100,000 Adults – 0.1-1.8/100,000 Age – typically diagnosed in children 3-10 years Majority are diagnosed in children 5 years Sex – M F, 1.5:1 Pathophysiology[arupconsult.com]
  • Pathophysiology The purple macules and patches of this condition occur because red blood cells leak into the dermal tissue.[dermaamin.com]

Prevention

  • Abstract Immunoglobulin G is used to both prevent infection in primary immunodeficiency diseases (PIDs) and prevent bleeding in immune thrombocytopenic purpura.[ncbi.nlm.nih.gov]
  • Eight studies evaluated therapy to prevent persistent kidney disease in HSP.[cochrane.org]
  • Finally, we will discuss the key factors that are involved in Th cell differentiation as potential novel targets for the prevention and treatment of HSP.[ncbi.nlm.nih.gov]
  • Can Henoch-Schönlein purpura be prevented or avoided? Doctors do not know how to prevent HSP. The disease is more common in boys than in girls. Children 2 to 11 years of age are more likely to be affected, but adults can get it too.[familydoctor.org]

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