May Week 4: Henoch Schoenlein Purpura

1. Diagnosis and Management of Henoch-Shonlein Purpura, McCarthy, Hugh, et. al., European Journal of Pediatrics. 2010.

CASE & Questions:

A 3 yo male presents with 2 weeks of a rash (shown below), which started as a maculopapular rash on the legs. He now has 3 days of abdominal pain also.  You measure his BP and it is 130/75.

1.  What is your diagnosis?

2. What is the pathophysiology of this diagnosis?

3. What is the only major criteria you need to make this diagnosis?

4. How does the renal dysfunction in this diagnosis usually manifest itself?

5. On histology, what finding represents more significant renal damage?

6. How can we prevent the severe renal disease that can be associated with this diagnosis?

7. Which anti-hypertensive medication should our patient take in this scenario?

8. When should you consult a nephrologist in the setting of this diagnosis?