She denied the use of any new medications but did report resuming use of pilocarpine 3 months prior to presentation and ursodiol 2 months prior to presentation. She had previously taken both of these medications without adverse effects. [mdedge.com]

It is the presenting sign in 50 percent of patients. 12 Some patients present with predominantly petechial lesions, some present with mainly purpuric lesions, and others present with a mixture of lesion types. [aafp.org]

Henoch Schönlein purpura The classic presentation of HSP is with a tetrad of symptoms and signs: rash arthritis abdominal pain kidney impairment. [dermnetnz.org]

• Pain

  Radiating pain in the legs Low back pain Edema Numbness in the lower extremities Pain in the trunk and extremities Abdominal pain Sciatica Aversion to Wind and Cold Knee pain T: Pale or Pink with purple spots C: Normal P: Choppy or Taut Treatment Principle [americandragon.com]

  Abdominal pain Joint pain Abnormal urine (may have no symptoms) Diarrhea, sometimes bloody Hives or angioedema Nausea and vomiting Swelling and pain in the scrotum of boys Headache Exams and Tests The health care provider will look at your body and look [ufhealth.org]

  In the skin, the disease causes palpable purpura (small, raised areas of bleeding underneath the skin), often with joint pain and abdominal pain. [en.wikipedia.org]

  The clinical triad of purpura, abdominal pain, and arthritis should raise concern. [aafp.org]

• Inflammation

  IgA vasculitis-related purpura is due to inflammation. Inflammation damages blood vessels and allows red blood cells to leak and cause a fine rash. It usually follows a respiratory illness, such as strep throat, but the exact cause is unknown. [verywellhealth.com]

  Purpura not due to a low platelet count, caused by inflammation in blood vessels of the skin, is the hallmark of HSP. The tetrad of purpura, arthritis, kidney inflammation, and abdominal pain is often observed. [hopkinsvasculitis.org]

  The immune complexes cause inflammation of the blood vessels. Inflammation of the blood vessels is known as vasculitis. [patient.info]

  Skin rash characteristics Vasculitis means inflammation of blood vessels. The vasculitis caused by HSP tends to target the capillaries of the skin and the kidneys. The inflammation of capillaries in the skin causes the characteristic rash. [betterhealth.vic.gov.au]

  Other common symptoms or signs of organ involvement include abdominal pain, joint pain and swelling, and kidney inflammation. [vasculitisfoundation.org]

• Swelling

  Swelling around the hand and wrist. Although arthralgias are more common in HSP, arthritis can occur as well as periarticular swelling, such as the tenosynovitis shown here. Figure 6. Swelling around the ankle and foot. Figure 7. [hopkinsvasculitis.org]

  Swelling Many children with HSP also have swelling over the backs of their feet and hands, and the scrotum in boys. How is Henoch-Schonlein purpura diagnosed? There is no specific laboratory test for the disease. [kidshealth.org.nz]

  Swelling (edema) around the joints – The swelling and pain sometimes can be severe enough that your child may have trouble walking. Smaller children may have swelling of the face and hands. Very rarely a child will have swelling in the genital area. [nationwidechildrens.org]

  […] mouth, esophagus, stomach and intestines Swollen kidneys Swelling just below the skin A brain disorder Inflammation of the testicles These symptoms can seem like other health conditions. [childrensnational.org]

  […] mouth, esophagus, stomach, and intestines Swollen kidneys Swelling just below the skin A brain disorder Inflammation of the testicles These symptoms can seem like other health conditions. [cedars-sinai.org]

• Weakness

  Asthma Restlessness Thirst Dark yellow urine Dyspnea Chest pain Shortness of breath Thick yellow Phlegm T: Red C: Thick and yellow, maybe dry and sticky P: Rapid, maybe slippery, maybe forceful Treatment Principle Clear Heat in Lungs Strengthen when weak [americandragon.com]

  Shortly following multiple tooth extractions she experienced weakness and malaise. She was found by a physician to be in mild congestive heart failure. [jamanetwork.com]

  Symptoms are due to blood clots, a low platelet count, and damaged red blood cells, purplish spots called purpura on the skin or in the mouth, paleness or jaundice, feeling tired or weak, fever, fast heart rate or feeling short of breath, headache, speech [seattlecca.org]

  Low platelet (a blood cell that stops your body from bleeding) levels Platelets that do not work correctly Injury to blood vessels Fragile or weak blood vessels An allergic reaction to a blood transfusion Certain viral or bacterial infections, such as [drugs.com]

• Amyloidosis

  Periorbital purpura or a purpuric rash that develops in a nonthrombocytopenic patient after gentle stroking of the skin suggests amyloidosis. [msdmanuals.com]

  Meningococcemia Rickettsial diseases Hepatitis C HIV Medications Propylthiouracil (PTU) Hydralazine NSAIDs Penicillin Anti-TNF factors Corticosteroids Congenital Hereditary hemorrhagic telangiectasia Ehlers-Danlos syndrome Trauma Other Vitamin C deficiency Amyloidosis [clinicaladvisor.com]

  Non-thrombocytopenic purpuras may be due to: Amyloidosis (disorder in which abnormal proteins build up in tissues and organs) Blood clotting disorders Congenital cytomegalovirus (condition in which an infant is infected with a virus called cytomegalovirus [nlm.nih.gov]

• Abdominal Pain

  pain, and arthritis may be in any sequence, although abdominal pain and arthritis are not universally present. [aafp.org]

  The abdominal pain and purpura resolved at discharge and there were no recurrences in the subsequent 3-, 6-, and 12-month follow-ups. [ncbi.nlm.nih.gov]

  pain Abdominal pain with spasms or radiates to back and waist Cannot eat Shortness of breath Dyspnea Pale face Intermittent spasmodic abdominal pain which is better with Heat and pressure Epigastric pain Lusterless complexion Fidgeting Reduced appetite [americandragon.com]

• Hematochezia

  Onset and duration Exposures to medications, drugs or chemicals Antecedent illnesses Associated symptoms ◦ Abdominal pain ◦ Hematochezia ◦ Arthralgias ◦ Fever ◦ Confusion ◦ Mucosal bleeding ◦ Hemarthrosis History of connective tissue disease or malignancy [clinicaladvisor.com]

  Second, on several occasions, the patient reported hematochezia in the absence of concomitant abdominal pain. [journals.lww.com]

• Melena

  […] constraint (e.g., from socks or clothing) Joints (∼ 75% of cases): : arthritis/arthralgia, most common in the ankles and knees Gastrointestinal tract (∼ 60% of cases) Colicky abdominal pain (may be severe enough to mimic an acute abdomen) Bloody stools or melena [amboss.com]

  She denied melena, hematochezia, and any urinary tract symptoms. Physical examination revealed diffuse tenderness in the epigastric area and a nonpalpable liver and spleen. [mdedge.com]

  Abdominal pain is often associated with diarrhea with gross or occult blood, nausea, vomiting, constipation, and gastrointestinal bleeding (hematemesis or melena). [intechopen.com]

  A barium enema study may be warranted for evaluating epigastric pain, hematemesis, and melena and for confirming and treating intussusception. [emedicine.medscape.com]

• Hematemesis

  […] with purple spots C: Normal P: Choppy or Taut Treatment Principle Unblock and relax the channels Invigorate the Blood Break up Blood Stasis Dispel Wind-Dampness Strengthen the tendons Herb Formulas Points Clinical Manifestations High fever Bleeding Hematemesis [americandragon.com]

  Other symptoms include nausea, vomiting, hematemesis, melena, and hematochezia. These symptoms are secondary to vasculitis involving the splanchnic circulation (mesenteric vasculitis). [hindawi.com]

  Abdominal pain is often associated with diarrhea with gross or occult blood, nausea, vomiting, constipation, and gastrointestinal bleeding (hematemesis or melena). [intechopen.com]

  A barium enema study may be warranted for evaluating epigastric pain, hematemesis, and melena and for confirming and treating intussusception. [emedicine.medscape.com]

  Patients may present with the following: Rash Joint pain Abdominal pain Vomiting Subcutaneous edema Rectal bleeding Scrotal edema Headache Fever Diarrhea Hematemesis Fatigue Physical Examination Skin Skin involvement is present in all patients with Henoch-Schonlein [ncbi.nlm.nih.gov]

• Thrombosis

  Virchow's triad Trousseau sign of malignancy By site Deep vein thrombosis Bancroft's sign Homans sign Lisker's sign Louvel's sign Lowenberg's sign Peabody's sign Pratt's sign Rose's sign Pulmonary embolism Renal vein thrombosis Bleeding By cause Thrombocytopenia [en.wikipedia.org]

  liver disease, use of anticoagulant and anti platelet medications, vitamin K deficiency, and massive transfusion Inherited Causes: Purpura Fulminans: Deficiency of Protein C, S or both. acute and rapidly progressive disorder in which intravascular thrombosis [imreference.com]

  Thrombosis does not take place readily in the injured vessels and the bleeding time is greatly prolonged. In 1775 Werlhof1 first described this disease and established it as a distinct clinical entity. In 1916 [jamanetwork.com]

  Consultative Hemostasis and Thrombosis. 3rd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap 11. Marks JG, Miller JJ. Purpura. In: Marks JG, Miller JJ, eds. Lookingbill and Marks' Principles of Dermatology. 5th ed. [nlm.nih.gov]

  Discussion Purpura fulminans refers to a rapidly progressive thrombotic disorder that manifests with disseminated intravascular coagulation, intravascular thrombosis, and haemorrhagic infarction of the skin.1 It can herald multiple organ failure and has [bmj.com]

• Arthritis

  Schönlein associated the purpura and arthritis, and Henoch the purpura and gastrointestinal involvement. [en.wikipedia.org]

  It is manifested with small hemorrhages in the skin, gastrointestinal symptoms, arthritis, and nephropathy. [icd10data.com]

  The arthritis symptoms include swelling, warmth, and tenderness. [aafp.org]

• Contusion

  […] pulmonary infection); immunologic phenomena (e.g., glomerulonephritis, Osler nodes, Roth spots); new valvular regurgitation Blood cultures drawn more than two hours apart, CBC, ESR, echocardiography Child abuse Worrisome skin marks (e.g., ecchymosis, shaped contusions [aafp.org]

• Purpura

  Picture of Henoch-Schonlein Purpura Henoch-Schonlein purpura is a condition that causes inflamed, leaky blood vessels. The photo depicts the foot of a child affected by the condition. Papules and hemorrhagic macules resembling hives are apparent. [emedicinehealth.com]

  Synonym: nonthrombocytopenic purpura anaphylactoid purpura Henoch-Schönlein purpura. purpura annularis telangiectodes Majocchi disease. fibrinolytic purpura Purpura resulting from excess fibrinolytic activity of the blood. purpura fulminans A rapidly [medical-dictionary.thefreedictionary.com]

  Purpura is usually one of the first signs. What is Purpura Fulminans Purpura fulminans is a rare but potentially life-threatening disorder, proving fatal in up to 50% of cases. [verywellhealth.com]

  From Wikipedia, the free encyclopedia Henoch–Schönlein purpura Other names IgA vasculitis,[1] anaphylactoid purpura,[2] purpura rheumatica,[2] Schönlein–Henoch purpura[2] Typical purpura on lower legs and buttocks Pronunciation Specialty Rheumatology, [en.wikipedia.org]

• Petechiae

  Compare petechiae and ecchymosis. purpura Visible hemorrhage into a mucocutaneous region. [medical-dictionary.thefreedictionary.com]

  Petechial haemorrhage, Petechial eruption, Petechial rash, Petechia (morphologic abnormality), petechia, Petechiae, hemorrhage; petechial, petechial; hemorrhage Dutch petechiën rash, petechie, rash met petechiën, petechiae, bloeding; petechiaal, petechiaal [fpnotebook.com]

• Skin Lesion

  Over 12 hours, the skin lesions evolved into irregular gangrenous purpura with a central dusky necrosis surrounded by fading redness (fig 2 ⇓ ). [bmj.com]

  A hospital admission was deemed necessary because of the severity of the skin lesions and the debilitating arthritis. [pediatrics.aappublications.org]

  The serological tests and other laboratory tests for etiology were performed and biopsy was taken from the skin lesions which are appropriate. [ard.bmj.com]

  The diagnosis of IgAV is based on a combination of factors, including: A physical examination that finds skin lesions and joint tenderness. Urinalysis that shows microscopic blood in the urine. Stool that has microscopic blood. [my.clevelandclinic.org]

• Skin Rash

  To use different ways of writing HSP reflecting the severity of the skin rash is interesting. Hakim is proposing that we use HSP if it is with a typical rash, HSp if it is with an atypical rash. [journals.lww.com]

  Skin rash characteristics Vasculitis means inflammation of blood vessels. The vasculitis caused by HSP tends to target the capillaries of the skin and the kidneys. The inflammation of capillaries in the skin causes the characteristic rash. [betterhealth.vic.gov.au]

  HSP causes a skin rash, pain in the large joints (such as knees, ankles and wrists) and stomach pain. The rash is called ‘Purpura’ and will appear as small bruises or reddish-purple spots usually on buttocks, around the elbows and ankles. [yeovilhospital.co.uk]

  It causes skin rashes that bleed into the skin (petechiae and purpura). Bleeding may also occur from the gastrointestinal tract and kidneys. [mountsinai.org]

  Classically, HSP causes a purple-appearing skin rash, pain in the abdomen, and joint inflammation (arthritis). Not all features need be present for the diagnosis. The rash of skin lesions appears in gravity-dependent areas, such as the legs. [medicinenet.com]

• Eruptions

  Price1 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]

  — Purpuric eruptions due to local mechanical causes are commonly seen, particularly in children. These eruptions are not always recognized as isolated purpura, and the patient may be submitted to an unnecessary extensive hematologic workup. [jamanetwork.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]

• Hematuria

  […] or proliferative glomerulonephritis with predominant IgA deposits Arthritis or arthralgias Renal involvement Indicators for Renal Involvement Proteinuria 0.3 g/24 hrs OR >30 mmol/mg of urine albumin to creatinine ratio on a spot morning sample AND/OR Hematuria [arupconsult.com]

  Treatment Principle Unblock and relax the channels Invigorate the Blood Break up Blood Stasis Dispel Wind-Dampness Strengthen the tendons Herb Formulas Points Clinical Manifestations High fever Bleeding Hematemesis Epistaxis Hemoptysis Hematochezia Hematuria [americandragon.com]

  Proliferative glomerulonephritis or leukocytoclastic vasculitis with predominant deposition of IgA on histology CLinicians should order a urinalysis to identify hematuria, proteinuria, or red blood cell casts. [ncbi.nlm.nih.gov]

  In a series comparing 85 HSP patients with 93 HV patients, five symptoms were found to be indicative of HSP: palpable purpura, abdominal angina, digestive tract hemorrhage (not due to intussussception), hematuria and age less than 20. [en.wikipedia.org]

  Urine analysis can vary from microscopic hematuria to nephritic-syndrome range proteinuria. Coagulation studies and the platelet count are usually normal. [clinicalmolecularallergy.biomedcentral.com]

• Metrorrhagia

  […] mental exhaustion Abdominal and epigastric distention after eating Maybe acid regurgitation or vomiting Loose or unformed stools Shortness of breath Dizziness Palpitations Functional Uterine Bleeding Purpura Epistaxis Hemafecia Hematuria Menorrhagia Metrorrhagia [americandragon.com]

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]

These eruptions are not always recognized as isolated purpura, and the patient may be submitted to an unnecessary extensive hematologic workup. We present various causes of suction purpura and outline a logical investigational approach.Observations. [jamanetwork.com]

Rocky mountain spotted fever HSP Non-palpable Purpura fulminans DIC TTP Afebrile, nontoxic Palpable Autoimmune vasculitis Non-palpable ITP Evaluation For children with fever and petechiae/purpura consider using the Barts Health NHS Trust guideline for workup [wikem.org]

Based on the pathophysiology that is suspected, a differential diagnosis can be generated and an appropriate workup can be initiated. [link.springer.com]

A laboratory workup, including a complete blood cell count and differential, prothrombin time, partial thromboplastin time, comprehensive metabolic panel, creatinine kinase test, urinalysis, and chest radiograph, was normal, but his erythrocyte sedimentation [mdedge.com]

• Decreased Platelet Count

  Purpura may occur with either normal platelet counts (non-thrombocytopenic purpuras) or decreased platelet counts (thrombocytopenic purpuras). [patient.info]

The treatment depends on the cause. Heparin-induced thrombocytopenia needs immediate treatment. Usually, the focus of treatment isn't the purpura itself, but the underlying condition that triggered it. [verywellhealth.com]

Treatment If patients are asymptomatic (i.e., have no active bleeding) and have platelet counts of about 50,000/mm 3, treatment is not needed (4 out of 5 patients recover without treatment). [medical-dictionary.thefreedictionary.com]

Treatment may be indicated on the basis of the appearance of the biopsy sample; various treatments may be used, ranging from steroids by mouth to a combination of intravenous methylprednisolone (steroid), cyclophosphamide and dipyridamole followed by [en.wikipedia.org]

They measure 0.3–1 cm (3–10 mm), whereas petechiae measure less than 3 mm, and echymoses greater than 1 cm Treatment Principle Herb Formulas Points Clinical Manifestations High fever Profuse perspiration Great thirst with a desire to drink Abdominal pain [americandragon.com]

Prognosis Gastrointestinal or pulmonary bleeding can be life-threatening. The long term prognosis depends on the extent of the renal involvement. [orpha.net]

Soler et al. 8 reported that the renal prognosis worsened in the presence of cellular crescents. [revistanefrologia.com]

Click here for example image of HSP Links: aetiology pathogenesis clinical features treatment and prognosis complications urticaria [gpnotebook.co.uk]

Both thrombocytopenia and purpura have been shown to have a complex etiologic pattern with multiple potential etiologic factors. [ashpublications.org]

Regarding the etiology, prodromal viral illness has been described as an etiology of HSP. Though there is a higher occurrence of HSP in the late fall and spring, some patients are seen throughout the year. [journals.lww.com]

The serological tests and other laboratory tests for etiology were performed and biopsy was taken from the skin lesions which are appropriate. [ard.bmj.com]

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]

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]

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]

The epidemiology, pathophysiology, clinical features, differential diagnosis and management of purpura and bruising due to different causes are discussed. The full text of this article hosted at iucr.org is unavailable due to technical difficulties. [onlinelibrary.wiley.com]

George at the Department of Biostatistics and Epidemiology, Hudson College of Public Health, University of Oklahoma Health Sciences Center, 801 NE 13th St., Oklahoma City, OK 73104, or at [email protected]. [nejm.org]

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]

Henoch-Schonlein purpura Summary Epidemiology Etiology Pathophysiology Clinical features History Manifestations Diagnostics Laboratory tests Imaging Biopsy Differential diagnoses Purpura Arthritis/Arthralgia Renal disease Treatment Mild disease Severe [amboss.com]

The epidemiology, pathophysiology, clinical features, differential diagnosis and management of purpura and bruising due to different causes are discussed. The full text of this article hosted at iucr.org is unavailable due to technical difficulties. [onlinelibrary.wiley.com]

Each of these morphologies is associated with a specific underlying pathophysiology. [link.springer.com]

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]

However, these pathologies can be quickly recognized, diagnosed, and treated when approached systematically and with an understanding of their underlying pathophysiology. [shmabstracts.org]

Control and prevention of meningococcal disease and control and prevention of serogroup C meningococcal disease: evaluation and management of suspected outbreaks. [pediatrics.aappublications.org]

Heparin-induced thrombocytopenia: Heparin is a drug used to prevent blood clots (anticoagulant). A severe reaction to it causes widespread blood clotting throughout the body. [verywellhealth.com]

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]