Vasculitis ( Pediatrics) Flashcards
Henoch-Schonlein purpura clinical picture and diagnosis.
IgA-mediated vasculitis :
■ Palpable purpura (usually lower extremities), joint pain, abdominal pain +/- intussusception, hematuria (IgA nephropathy).
● Usually occurs after viral/streptococcal upper respiratory infection.
● If severe abdominal pain, do US to check for intussusception.
Henoch-Schonlein purpura lab findings
Normal platelets/ coagulation (distinquish from ITP).
Normal to increased creatinine.
Hematuria.
+/-RBCs casts and proteinuria.
Henoch-Schonlein purpura treatment
● Usually supportive (hydration/NSAIDs).
● If severe GI pain/ renal involvement, use steroids.
● If hypertensive, use ACE-inhibitors.
● Conduct regular urinalysis for the first 6 months after diagnosis to re-evaluate if it becomes chronic IgA nephropathy.
Definition of Kawasaki Disease
Multisystem inflammation of medium-sized blood vessels.
Peak incidence between 6-11 months, usually before age 4.
Clinical presentation and symptoms of Kawasaki Disease
CRASH and Burn: mnemonic :
● C: Conjunctivitis (bilateral)
● R: Rash. Polymorphic, typically truncal. Later becomes desquamating. Includes palms/soles
● A: Adenopathy (cervical)
● S: Strawberry tongue (oral mucositis)
● H: Hand/feet erythema/edema.
● Burn: Fever > 5 days w/o explanation (typically 39-40 ℃). Usually self-limited fever lasts 12-14 days.
Labs of Kawasaki Disease
ESR, CRP, WBC are all really high.
Complications of Kawasaki Disease
High risk of coronary artery aneurysm with thrombosis.
Perform repeated echos to monitor.
Give aspirin.
Differential Diagnosis of Kawasaki Disease
Scarlet fever
EBV
Drug reaction
Systemic JIA
Sepsis
Treatment of Kawasaki Disease
IVIG & aspirin to prevent clot formation.
Decrease inflammation.
Give steroids if refractory to IVIG.
