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Pathology

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CVS

Question
11 out of 20
 

A 5 year old child presents with perivascular deposition and neutrophilic collection. There erythematous rash on the lower limbs and non- blanching purpura. The likely diagnosis in the child is: (AIIMS May 2012)



A Henoch-Schonlein Purpura

B Wegner's granulomatosis

C Giant cell Vasculitis

D Kawasaki's disease

Ans. A Henoch-Schonlein Purpura

Henoch-Schonlein Purpura (HSP) is a syndrome seen in children (3-8 years of age) consisting of purpuric sin lesions characterisitically involving the extensor surface of arms and legs as well as buttocks; abdominal manifestations including pain, vomiting, and intestinal bleeding; nonmigratory arthralgia; and renal abnormalities. It follows an upper respiratory infection.

A history of atopy is present.

The renal manifestations may including gross or microscopic hematuria, proteinuria, and nephritic syndrome and is seen in 1/3rd of the patient. IgA is deposited in the glomerular mesangium.

Microscopically

Kidney has deposition of IgA, sometimes with IgG and C3, in the mesangial region.

The skin lesion consists of subepidermal hemorrhages ad a necrotizing vasculitis with IgA deposition involving the small vessels of the dermis.

Vasculitis also occurs in ther organs. Such as the gastrointestinal tract, but is rare in the kidney.

Wegner’s granulomatosis and Giant cell Vasculitis are not seen in children. Options ‘b’ and ‘c’ are ruled out. Kawasaki’s disease affects children but the presentation is fever, cervical Iymphadenopathy, skin rash, oral ulcers, conjunctivitis and edema of hands and feet. So, option‘d’ is also ruled out.

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