A 20-year-old previously healthy man presented with progressive rash, low-grade fever and arthralgia that involved the knees and ankles that had lasted for 2 months despite treatment with oral prednisolone and naproxen, arthralgia is under control, but rashes developed more. Physical examination showed diffuse palpable purpura distal to the knees (Panel A). The ESR and C-reactive protein level were elevated (43 mm/hr [normal value, 0-14] and 25.40 mg/L [normal value 0.00-10.00], respectively), urinalysis disclosed urine blood, urine protein and RBC (963 cells/uL [normal value, 0-3]), but other laboratory tests, including platelet count and immunology, were normal. What is a possible diagnosis of this case?
A small vessel vasculitis SVV or Henoch–Schönlein purpura (HSP) is a form of leukocytoclastic vasculitis, , causes palpable purpura in the lower extremities, arthralgia, and glomerulonephritis. HSP generally affects children, but it may also occur in adult life. The most common symptoms include a vasculitic rash, joint pain, and abdominal pain. It may affect the kidneys and in some instances, this leads to irreversible kidney damage. The patient was treated with herbal medicine at Tangs Clinical Centre TCM, he was doing well at follow-up 3 months after the herbal treatment.
一名20岁的健康男性出现进行性皮疹，低烧和膝踝关节痛2个月余，尽管用口服泼尼松龙和萘普生治疗，关节痛止，但是皮疹增多。体检显示膝盖远端弥漫性可触及的紫癜（图A）。 ESR和C反应蛋白水平升高（分别为43 mm / hr [正常值，0-14]和25.40 mg / L [正常值0.00-10.00]），尿液分析显示血尿，蛋白尿和红细胞（963 个细胞/ uL [正常值，0-3]），但其他实验室检查，包括血小板计数和免疫学检查均正常。这种情况可能的诊断是什么？