Diferencia entre revisiones de «Henoch-Schonlein purpura»
(Created page with "==Background== -HSP, aka anaphylactoid purpura -systemic vasculitis associated with abdominal pain and rash -usually age 4-11, may occur in adults -commonly occurs in spring...") |
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==Background== | ==Background== | ||
-HSP, aka anaphylactoid purpura | -HSP, aka anaphylactoid purpura | ||
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-commonly occurs in springtime after viral URI | -commonly occurs in springtime after viral URI | ||
==Diagnosis== | ==Diagnosis== | ||
-clinical diagnosis based on presence of abdominal pain, classic rash, microscopic hematuria, arthralgias in otherwise well appearing child | -clinical diagnosis based on presence of abdominal pain, classic rash, microscopic hematuria, arthralgias in otherwise well appearing child | ||
| Línea 22: | Línea 16: | ||
-intussusception: ileoileal more common than ileocolic inpatients with HSP | -intussusception: ileoileal more common than ileocolic inpatients with HSP | ||
==Work-Up== | ==Work-Up== | ||
#CBC, Chem7 | |||
#UA | |||
#Blood cx | |||
#ESR | |||
#consider CT abdomen (ileoileal intussusception difficult to detect by US) | |||
==DDx== | ==DDx== | ||
#meningococcemia (febrile, ill appearing) | |||
#erythema nodosum | |||
==Treatment== | ==Treatment== | ||
*dz self limited: 94% recover completely | |||
*consider corticosteroids for severe disease (abdominal pain, hematuria, arthralgias) | |||
**prednisone 1mg/kg/day | |||
==Disposition== | ==Disposition== | ||
*most patients managed safely as outpatient | |||
*consider admission for: | |||
**uncertain diagnosis to exclude possibility of meningococcemia | |||
**severe abdominal pain and vomiting | |||
==Source== | ==Source== | ||
Adapted from Rosens 7th edition | Adapted from Rosens 7th edition | ||
[[Category:Peds]] | [[Category:Peds]] | ||
Revisión del 19:32 7 jun 2011
Background
-HSP, aka anaphylactoid purpura
-systemic vasculitis associated with abdominal pain and rash
-usually age 4-11, may occur in adults
-commonly occurs in springtime after viral URI
Diagnosis
-clinical diagnosis based on presence of abdominal pain, classic rash, microscopic hematuria, arthralgias in otherwise well appearing child
-symptoms: abdominal pain, nausea, vomiting, diarrhea, rash, mild arthralgias
-rash: palpable purpura on buttocks and lower extremities
-intussusception: ileoileal more common than ileocolic inpatients with HSP
Work-Up
- CBC, Chem7
- UA
- Blood cx
- ESR
- consider CT abdomen (ileoileal intussusception difficult to detect by US)
DDx
- meningococcemia (febrile, ill appearing)
- erythema nodosum
Treatment
- dz self limited: 94% recover completely
- consider corticosteroids for severe disease (abdominal pain, hematuria, arthralgias)
- prednisone 1mg/kg/day
Disposition
- most patients managed safely as outpatient
- consider admission for:
- uncertain diagnosis to exclude possibility of meningococcemia
- severe abdominal pain and vomiting
Source
Adapted from Rosens 7th edition