Diffuse tender edema and intussusception: an unusual initial presentation of Henoch-Schonlein purpura

2nd Edition of International Congress on Pediatrics
March 26-27, 2018 Edinburgh, Scotland

Kyrina Anastasia, Krepis Panagiotis, Ioannis Leptidis, Korexenidou Magda and Zarkinos Fotios

National and Kapodistrian Athens University, Greece

Posters & Accepted Abstracts: J Pediatr Care

DOI: 10.21767/2471-805X-C1-006

Abstract

An 8-year old boy was admitted with a 72 h history of painful swelling of the upper and lower limbs. The oedema had been worsening within the last 24 h and he refused to walk and also reported non-focal abdominal pain that begun 4 days ago. He had no remarkable history apart from a drop off his bicycle 4 days ago after which he was examined in the emergency department and no serious trauma were found. Physical examination revealed painful pitting edema of the limbs along with periorbital oedema, scrotal swelling and a small non-blanching rash on the limbs and on the abdomen that was barely seen. Laboratory assessment showed mild thrombocytosis, increased ESR and decreased serum albumin. He started complaining of severe abdominal ache and subsequently, an abdominal ultrasound was performed and showed small bowel intussusception that was also confirmed by CT. Ninety six hours after the initiation of the edema, palpable purpuric lesions indicative of Henoch-Schonlein purpura (HSP) were appeared on the boy��?s legs. Therefore, the patient was administered steroids and showed remarkable clinical improvement. Facial edema in HSP have been previously described mainly in children less than two years old, in this case not only the primary edema was prominent and involved multiple body parts, but also it was spread all over his body. Non-typical, subcutaneous edema involving one or multiple parts of the body represents a severe feature of HSP that may precede the purpuric rash. Thus, pediatricians should be aware of this possibility and should always have a high index of suspicion for HSP.

Biography

Kyrina Anastasia has completed her Medical studies from National and Kapodistrian Athens University. She has worked as a Pediatric Trainee at General Hospital of Kozani in Greece. She has done her neonatal rotation at Chelsea and Westminster Hospital in London. She is now a Clinical Fellow in Pediatrics and Neonates at Countess of Chester Hospital in Liverpool. Email:anastasiakir@hotmail.com

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