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7/30/2019 henosh shnelein purpura
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varies from 6 months toadulthood, peak incidence is 2-8 years.
aredeposited on arterioles, capillaries, and
venules.
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Almost in all cases
Begins as: maculopapular rash petechiae &purpura.
Symmetric, over extensor surfaces & buttocks
Lesions occur in cropsand last 3-10days.
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Occurs in: 80% of cases.
Prominent whichsometimes tender but without erythema andwarmth.
(if present) are serous (nothemorrhagic).
Symptoms are (resolves in a few days)with no permanent damage to the joints.
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Of the 40% of patients who develop kidneyinvolvement, almost all have evidence (visibleor on urinalysis) of blood in the urine. Morethan half also have proteinuria.
but nephrotic syndrome, HTN, acute renal
failure can occur
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Occurs in 62% of cases.
The is colicky in character, and
may be accompanied by.
Complicated by: gastrointestinal hemorrhage,
bowel ischemia and necrosis, intussusceptionand bowel perforation.
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Occurs in 1.3-13.6% of reported series.
The is usually a
are
In contrast to idiopathic intussusception where 80-
90% are .
incases of intussusceptions in HSP as they are oftenconfined to the small bowel
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especially when the child already hasabdominal symptoms & signs.
inview of the underlying intestinal vasculitis &may not be accessible by the enema as it isusually located in the small intestine.
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A -year-old was admitted toour institute with a
history ofon the buttocks
and the extensor aspects of the
forearm and. Urinalysis revealed
microscopic .
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On the next day, she sufferedof ,
tenderness all over theabdomen and.
showed bilious drainage.
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A togetherwith confirmed thediagnosis of intussusceptions.
in view of the patientsclinical condition as well as theunderlying vasculitis.
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At , anwas identified and
reduced manually with somedifficulty.
Though the bowel was congestedlooking and viable, a
was found
and resection with primaryanastomosis was mandatory.
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The post-operative period:
showed till she passed stool and
tolerated oral feeding beforebeen discharged on the 5thpostoperative day.
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