Post-streptococcal small-vessel vasculitis in a 16-month-old with associated intussusception and hypertension: Henoch

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Sara Banbury1, David M Milgraum2, Daniel J Lewis3

  • 1Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

Pediatric Dermatology
|April 17, 2024
PubMed

Insights

Henoch Schönlein purpura (HSP), or IgA vasculitis, usually affects older children. This case highlights HSP in a younger child, emphasizing the need for early diagnosis in all pediatric age groups.

Area of Science:

  • Pediatric Rheumatology
  • Immunology
  • Nephrology

Background:

  • Henoch Schönlein purpura (HSP), also known as IgA vasculitis, is a common childhood vasculitis.
  • It typically presents in children aged 3-15 years, with a peak incidence between 4-6 years.
  • Classic symptoms include palpable purpura, joint pain, abdominal pain, and kidney involvement.

Observation:

  • This report details a 16-month-old patient with clinical manifestations suggestive of HSP.
  • The patient presented with symptoms consistent with HSP but had negative IgA immunofluorescence.
  • This presentation is notably younger than the typical demographic for HSP.

Findings:

  • The case demonstrates that IgA vasculitis can occur in infants younger than typically reported.
  • Negative IgA immunofluorescence does not exclude a diagnosis of HSP in the appropriate clinical context.
  • The constellation of purpura, arthralgia, abdominal pain, and renal involvement remains key for diagnosis.

Implications:

  • Early recognition of vasculitis in young children is crucial for timely intervention.
  • Prompt diagnosis and management can prevent long-term complications, especially renal sequelae.
  • This case broadens the age spectrum considered for Henoch Schönlein purpura diagnosis.

Keywords:
Henoch Schönlein purpurahypertensionintussusceptionpediatric vasculitispost‐streptococcal vasculitis

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