Two Cases Report of Children IgA Vasculitis (Henoch-Schönlein purpura) HSP 儿童过敏性紫癜二例
Case 1
A 12-year-old girl developed bleeding spots and a red rash on her lower limbs with mild itching after catching a cold and running a fever one month ago. The local hospital diagnosed her with Henoch-Schönlein purpura and admitted her for treatment. She received intravenous infusions of 20 milligrams of dexamethasone daily for seven days. After discharge, she was prescribed 5 milligrams of oral steroids daily for an additional seven days. Laboratory tests revealed traces of protein and red blood cells in her urine, along with elevated lymphocytes, monocytes, and neutrophils.
Concerned about their daughter’s condition, her parents contacted our clinic seeking a traditional Chinese medicine (TCM) treatment plan. Based on the photos of the patient’s rash, which showed small dark purple bumps, ecchymosis, and inflammatory swelling of the extremities, we noted that the rash was symmetrical. The patient claimed no abdominal pain or joint pain.
We advised the patient to stop taking steroids and switch to oral TCM treatment. After one month, the purpura rash began to fade, and after three months, it significantly diminished. The rash became completely non-itchy. Continued treatment for five months resulted in the complete disappearance of the rash. At a follow-up at seven months later, both urine and blood tests showed normal range.
Case 2
A previously healthy 10-year-old girl suddenly developed raised red papules on her feet and ankles six days ago. The rash, although elevated above the skin’s surface, did not cause any itching or pain. Furthermore, she did not complain any general discomfort.
On examination, purplish-red spots and patches were observed on her both lower legs. These rashes appeared as slightly raised bumps above the skin, resembling bruises. Based on these findings, a provisional diagnosis of Henoch-Schönlein purpura was made. To address her condition, a customized oral traditional Chinese medicine (TCM) treatment was prescribed. Remarkably, after one month of treatment, the purpura rash significantly faded. As time went on, the rash continued to improve, ultimately disappearing completely after three months.
Discussion
Henoch-Schönlein purpura (HSP), also know as IgA vasculitis, is a condition characterized by inflammation of the small blood vessels in the body. It commonly affects children and is characterized by tetrad of symptoms and signs: rash, arthritis, abdominal pain and kidney impairment.
1. Skin rash: HSP typically presents with a distinctive rash known as purpura. These are small, purplish-red spots or patches that appear on the skin. The rash is usually located on the lower legs and buttocks but can also affect other areas of the body.
2. Joint pain: Many individuals with HSP experience joint pain, particularly in the knees and ankles. This pain may be intermittent and can range from mild to severe.
3. Gastrointestinal symptoms: HSP can also cause gastrointestinal symptoms, such as abdominal pain, nausea, vomiting, and occasionally, blood in the stools. These symptoms may be accompanied by a loss of appetite.
4. Kidney involvement: In some cases, HSP can affect the kidneys, leading to symptoms like blood in the urine, swelling in the legs and face, and decreased urine output. Kidney involvement requires close monitoring and medical intervention.
5. Systemic symptoms: Although less common, HSP can also cause systemic symptoms, including fever, fatigue, and general malaise.
Privacy
In situations where the disease information had already been made publicly available (as evidenced by prior articles), genuine names of individuals have been utilized. Conversely, in instances where there was no pre-existing public disclosure or at the explicit request of patients for privacy, pseudonyms have been employed. Furthermore, identities have been deliberately obscured, and certain contextual details and diagnoses have been modified to hinder any attempts at identification. It is essential to emphasize that the patients and encounters described in this work are authentic, and their consent for publication was duly obtained. As responsible authors, we earnestly implore all our readers to honor the privacy and confidentiality of these individuals. Additionally, certain scenarios, assessments, and clinical interventions have been altered to safeguard the anonymity of both patients and healthcare providers.
