{"id":2913,"date":"2010-03-06T00:56:04","date_gmt":"2010-03-06T05:56:04","guid":{"rendered":"http:\/\/insidesurgery.com\/?p=2913"},"modified":"2010-03-06T21:42:33","modified_gmt":"2010-03-07T02:42:33","slug":"henochschonlein-purpura-anaphylactoid-purpura","status":"publish","type":"post","link":"https:\/\/insidesurgery.com\/2010\/03\/henochschonlein-purpura-anaphylactoid-purpura\/","title":{"rendered":"Henoch-Schonlein Purpura (Anaphylactoid Purpura)"},"content":{"rendered":"
Pathophysiology<\/strong><\/p>\n 1)<\/strong> type of small vessel vasculitis thought to be secondary to immune complex deposition 2)<\/strong> most commonly occurs in children, but can occur in adults 3)<\/strong> typically self-limited<\/p>\n Signs and Symptoms<\/strong><\/p>\n 1)<\/strong> palpable purpura – most common over legs and buttocks 2)<\/strong> polyarthralgias – typically knees and ankles 3)<\/strong> GI complaints – colicky abdominal pain, nausea, vomiting, bloody diarrhea, and constipation 4)<\/strong> blood and mucus per rectum 5)<\/strong> glomerulonephritis – usually resolves spontaneously 6)<\/strong> myocardial dysfunction – adults only<\/p>\n Characteristic Test Findings<\/strong><\/p>\n Laboratory<\/em> – 1)<\/strong> proteinuria 2)<\/strong> microscopic hematuria 3)<\/strong> RBC casts in urine 4)<\/strong> increased serum IgA 5)<\/strong> eosinophilia 6)<\/strong> mild leukocytosis 7)<\/strong> all coagulation tests are normal<\/p>\n Histology\/Gross Pathology<\/strong><\/p>\n 1)<\/strong> IgA deposits in walls of dermal blood vessels 2)<\/strong> increased vascular permeability 3)<\/strong> glomerular lesions identical to IgA nephropathy (Berger’s disease)<\/p>\n Associated Conditions<\/strong><\/p>\n increased incidence with<\/em> – 1)<\/strong> upper respiratory tract infection 2)<\/strong> immunizations 3)<\/strong> insect bites 4)<\/strong> streptococcus pharyngitis<\/p>\n Biochemistry<\/strong><\/p>\n IgA is predominant antibody class in deposited immune complexes<\/p>\n Inheritance\/Epidemiology<\/strong><\/p>\n 1)<\/strong> peak incidence in spring 2)<\/strong> slightly more common in males<\/p>\n Treatment<\/strong><\/p>\n 1)<\/strong> glucocorticoids (prednisone) decrease GI complaints and joint pain but do not alter overall course 2)<\/strong> if renal failure is rapidly progressive (which is uncommon), plasmapheresis and immunosuppressive drugs are used<\/p>\n Tips for USMLE<\/strong><\/p>\n if questions mentions a 6 year-old boy with a bad cold who 2 weeks later develops red, raised lesions on his buttocks and the back of his thighs, sore ankles, and abdominal pain, think Henoch-Schonlein purpura<\/p>\n","protected":false},"excerpt":{"rendered":" Pathophysiology 1) type of small vessel vasculitis thought to be secondary to immune complex deposition 2) most commonly occurs in children, but can occur in adults 3) typically self-limited Signs and Symptoms 1) palpable purpura – most common over legs and buttocks 2) polyarthralgias – typically knees and ankles 3) GI complaints – colicky abdominal […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[63],"tags":[1417,1415,1416,1414],"yoast_head":"\n