Haematology and oncology
Jagdish M. Gupta, John Beveridge in MCQs in Paediatrics, 2020
9.21. Which of the following statements is/are true of anaphylactoid (Henoch-Schönlein) purpura?The platelet count is less than 100 × 10 9/1.Microscopic haematuria may persist for more than 1 year.Intussusception is a recognized complication.The arthritis may lead to joint deformity.There is evidence to suggest that it is an immune complex disease.
Haematology
Michael McGhee in A Guide to Laboratory Investigations, 2019
Acute idiopathic thrombocytopenic purpura is most commonly seen 2–3 weeks after an upper respiratory infection. In children, especially boys, Henoch-Schönlein purpura may present with a rash, most commonly distributed on the extensor surfaces and buttocks, accompanied by fever, myalgia, joint pains, abdominal pain and glomerulonephritis.
Unexplained Fever Associated With Cutaneous Manifestations
Benedict Isaac, Serge Kernbaum, Michael Burke in Unexplained Fever, 2019
In Henoch-Schonlein purpura (syn. anaphylactoid purpura), the fever may precede, together with other prodromal symptoms, the papular, urticarial, and purpuric lesions, associated with polyarthralgia and abdominal symptoms.
Predictive role of laboratory markers and clinical features for recurrent Henoch-Schönlein Purpura in childhood: A study from Turkey
Published in Modern Rheumatology, 2020
Şule Gökçe, Zafer Kurugöl, Güldane Koturoğlu, Aslı Aslan
Henoch Schönlein Purpura (HSP), also known as immunoglobulin A (IgA) vasculitis, is the most common vasculitis that affects the small vessels of the skin, joints, gastrointestinal tract and kidneys in childhood. It was originally recognized in 1801 by Heberden and described as having an association with arthritis by Schonlein in 1837. The disease is characterized by the quadruple of palpable purpura, abdominal pain, arthritis, and nephritis. It is seen with an incidence of about 20 cases per 100,000 yearly [1]. HSP is a type III hypersensitivity reaction mediated small vessel vasculitis. Purpuric skin lesions are the most common findings in HSP. Biopsy of the skin lesions characteristically demonstrates leukocytoclastic vasculitis which could also be seen in other types of vasculitis. Possible trigger factors have been reported including respiratory system infections, drugs, vaccines, and other environmental exposures [2,3]. Although the etiology of HSP is not clearly known, there is evidence to support immunopathological mechanisms. Renal and skin biopsies have shown that widespread abnormalities in IgA and IgA immune complexes such as IgA Rheumatoid factor (RF), IgA Anti-Neutrophil Cytoplasmic Antibody (ANCA) [4].
Protocols for drug allergy desensitization in children
Published in Expert Review of Clinical Immunology, 2020
Lucia Diaferio, Mattia Giovannini, Evangéline Clark, Riccardo Castagnoli, Davide Caimmi
Several other drugs have been administered through DDS protocols in pediatrics, whenever they are essential for the patient: for example, there are publications on antiepileptic drugs including valproic acid [95] and phenobarbital [55], gonadotropin-releasing hormone analog triptorelin acetate [96], recombinant human erythropoietin [97], deferasirox [98], …. Moreover, Guvenir et al. [99] reported on the first pediatric case of successful desensitization to methylprednisolone in a 6-year-old boy who had previously experienced an anaphylactic reaction to this drug, while being treated for Henoch–Schönlein purpura. The desensitization was performed using three different solutions that contained 0.04, 0.4, and 4 mg/ml concentrations of methylprednisolone. The desensitization protocol was completed in a total of 12 steps and the patient could tolerate the drug without reaction after desensitization.
Infection-related hospitalization after intensive immunosuppressive therapy among lupus nephritis and ANCA glomerulonephritis patients
Published in Renal Failure, 2020
Peihong Yin, Jianbo Li, Qiong Wen, Yagui Qiu, Wenyi Liang, Junxian Wang, Jing Yu, Zhong Zhong, Xiao Yang, Xueqing Yu, Qing Ye, Fengxian Huang
This was a retrospective study. All inpatients diagnosed with LN or ANCA glomerulonephritis at the First Affiliated Hospital of Sun Yat-sen University from 1 January 2005 to 31 December 2014 were screened. All of the selected patients fulfilled the following inclusion criteria: ① age ≥18 years; ② intensive immunosuppressive therapy initiated at our hospital; and ③ regular follow-up. Intensive immunosuppressive therapy was defined as therapy with glucocorticoids and immunosuppressants [18]. Regular follow-up means that patients visited specialist physicians regularly every 1–3 months. Patients who had already received immunosuppressive therapy at another medical institution before admission to our hospital, were in poor compliance, or had a history of renal replacement therapy were excluded. Poor compliance was defined when medical records (electrical or manual) were unavailable due to telephone-confirmed irregular follow-up of patients. All LN patients fulfilled the 1997 revised SLE classification criteria of the American College of Rheumatology with renal damage [19]. All ANCA glomerulonephritis patients met the criteria for ANCA-associated vasculitis outlined by the Chapel Hill Consensus Conference; ANCA glomerulonephritis patients with secondary SLE, rheumatoid arthritis, anaphylactoid purpura, drug abuse, or infection were excluded from the analysis [20]. This study was approved by the ethics committee of the First Affiliated Hospital of Sun Yat-sen University. Informed consent was waived by the committee because of the retrospective nature of the study.