Mesenteric lymphadenitis of Henoch-Schonlein purpura in children: A case report

M. Faza Akroma, Hudi Wiyasari
HVA Hospital Toeloengredjo Pare, Kediri, Indonesia.
Department of Pediatric, HVA Hospital Toeloengredjo Pare, Kediri, Indonesia.

Henoch-Schönlein purpura (HSP) is a systemic vasculitis involving small vessels with the deposition of immune complexes containing IgA. HSP primarily affects children, and its annual incidence is estimated to be 15 cases/100,000 per year in children compared to 1.3 cases/100,000 per year in adults. Peak age incidence is 4–6 years and 90% of HSP cases occur before the age of 10 years. Research showed several differences in the clinical features of HSP between adults and children. Associated findings include free intraperitoneal fluid, ileus of the affected loop, vascular engorgement in the adjoining mesentery and non-specific lymphadenopathy. We report a 6-years-old female presented with severe abdominal pain for two days before entering the hospital. Before it, abdominal pain has started to appear for one week, but sometimes and mild. Other symptoms are skin rashes and joint pain for nearly 9 days. The skin rashes initially appeared in bilateral leg which then progressed to bilateral thigh, gluteal region and hands. Skin rashes without fever, epistaxis, hematemesis, and melena. The patient did not complain of vomiting. Patients without complaint of seizure. Normal defecation and normal urination. Physical examination showed erythematous, palpable, purpuric rashes on the upper extremities and lower extremities. Upper and lower abdomen ultrasonography showed mesenteric lymphadenitis, consistent with the diagnosis of HSP. We report on the clinical presentation of our patient and review Children-onset HSP.

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