A 6-year-old boy presents with fever and a rash on his lower limbs, 2 weeks after developing a sore throat. There is also a history of abdominal pain and painful knees and ankles.... A 6-year-old boy presents with fever and a rash on his lower limbs, 2 weeks after developing a sore throat. There is also a history of abdominal pain and painful knees and ankles. Physical examination confirms palpable purpuric lesions on the lower limbs that do not blanch on pressure (see lab result). Test Result Normal Value ESR 92 2-10 mm/h. Which of the following is the most likely diagnosis? Read more

Understand the Problem

The question describes a clinical scenario of a young boy presenting with symptoms including fever, rash, sore throat, abdominal pain, and joint pain, along with lab results indicating an elevated ESR. The key feature is palpable purpura on the lower limbs. The question asks for the most likely diagnosis given the information.

More Information

Henoch-Schönlein purpura (HSP), also known as IgA vasculitis, is a condition that causes inflammation and bleeding in small blood vessels. It commonly affects children, and is characterized by a purplish rash, often on the lower legs and buttocks, joint pain, abdominal pain, and sometimes kidney involvement. It often follows an upper respiratory infection such as a sore throat.

Tips

It is a common mistake to confuse HSP with other vasculitis or bleeding disorders. Key differentiating factors include the typical distribution of the rash, the presence of abdominal pain, and joint involvement.

Sources

• Henoch-Schonlein purpura - Symptoms & causes - Mayo Clinic - mayoclinic.org
• Kids Health Info : Henoch-Schönlein purpura (HSP) - rch.org.au
• Henoch-Schönlein Purpura (HSP) (for Parents) | Nemours KidsHealth - kidshealth.org