[aktorque]

A 7 y/o boy presents with a low grade fever, arthralgias, colicky abdominal pain, and a palpable purpuric rash limited to the lower extremities. Laboratory studies reveal a guaiac positive stool, a urinalysis with red blood cell casts, hematuria, and mild proteinuria, and a CBC with a normal Hb, Hct and platelet count. Which of the following is the most likely diagnosis?

A. Thrombotic thrombocytopenic purpura
B. Systemic Lupus Erythematosus
C. Poststreptococcal Glomerulonephritis
D. Rocky Mountain Spotted Fever
E. Henoch-Schönlein purpura
F. Hemolytic-uremic syndrome

I want you to think all night and I'll give you the answer by tomorrow... have fun guys

feel :sleepy:

 

[doctorsmonsters]

I would go with:
E. Henoch-Schönlein purpura

 

[ms.med]

E- HSP

Hematuria, palpable purpura of lower extremities, IgA association.

Although I have read that there is still debate around its association with Celiac disease...please talk about this in your answer!

 

[doctorsmonsters]

E- HSP

Hematuria, palpable purpura of lower extremities, IgA association.

Although I have read that there is still debate around its association with Celiac disease...please talk about this in your answer!

Celiac disease won't have the findings mentioned in urinalysis I think.

 

[ms.med]

I somehow magically thought I read gluten somewhere where it says guaiac...
:redcheeks;

 

[pakbrain]

findings point toward SLE so i think its SLE

 

[pnreddy]

the answer is e..henoch schonlein purpura:happy:

 

[usmle0987]

E.

E. Henoch-Schönlein purpura is associated with URI (fever), Polyarthralgia (arthalgia), Nephropathy (casts), GI bleeding (Guaic+ stool). They present with palpable purpura on buttocks and lower extremities.

 

[geof1]

E
HSP ...i think

 

[dr_mhm]

The answer is E. HSP.

 

[aktorque]

E) Henoch-Schonlein purpura

Correct asn is E) Henoch-Schonlein purpura

Henoch-Schonlein purpura is a disease that involves purple spots on the skin, joint pain, gastrointestinal problems, and glomerulonephritis

Henoch-Schonlein is caused by an abnormal response of the immune system. It is unclear why this occurs.

The syndrome is usually seen in children, but it may affect people of any age. It is more common in boys than in girls. Many people with Henoch-Schonlein purpura had an upper respiratory illness in the weeks before.

Henoch-Schönlein purpura (HSP) is a small-vessel vasculitis in which complexes of immunoglobulin A (IgA) and C3 are deposited on arterioles, capillaries, and venules. As with IgA nephropathy serum levels of IgA are high in HSP and there are identical findings on renal biopsy.

Platelet count and coagulation studies: Platelet count is usually in the reference range but may be elevated; the platelet count should not be low in Henoch-Schönlein purpura. A normal platelet count rules out idiopathic thrombocytopenic purpura (ITP). A normal platelet count and normal coagulation studies (ie, PT, aPTT, fibrin split products) rule out thrombotic thrombocytopenic purpura (TTP).

Purple color rash, especially involving the legs
Subcutaneous edema
Abdominal pain and vomiting
Joint pain, especially involving the knees and ankles
Scrotal edema
Bloody stools


click image to enlarge

 

[drarnab]

I remember HSP as GI JOK(e) - GI, Joint + Kidney

 

[roshan dinparast]

for those guys who think this is lupus

lupus has 11 criteria, and the patient should fill at least 4 of them.in this case, the only criteria for SLE is nephropathy maybe.he dosent have arthritis,auto-antobadies(ANA),malar rash,cytopenias,...