A 6 yr old child presents with pain abdomen ,palpable purpura,rash and arthritis .the diagnosis is
a)typhoid
b)meningococcal infection
c)contact dermatitis
d)Henoch schonlein purpura
ANSWER: d.(Henoch schonlein pupura)
Discussion: reference Harrisons 17th ed
Henoch schonlein purpura:
- It is a vasculitis of small vessels.
- It is most common in children of age 4-7 yrs age.but also can seen in infants and adults.
- The pathogenic mechanism behind it is immune complex deposition.
- the most common antibody involved is IgA type.
- Clinical features:
- Palpable purpura:over buttocks and lower limbs.
- Polyarthralgia but no arthritis.(large joints).
- Colicky abdominal pain,diarrhoea/constipation .
- Mild glomerulonephritis-proteinuria,RBC casts,mic.hematuria
- platelet count is normal .
- serum complement levels are normal.
- TREATMENT: steroids(glucocorticoids).
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