Management of Henoch-Schonlein Purpura Treated with Oral Steroids | Chapter 7 | Current Practice in Medical Science Vol. 1

A 38-year-old man with irritable bowel syndrome (IBS) visited the clinic complaining of acute rash and severe central abdominal discomfort. The day before visiting the clinic, the patient visited the Emergency Department (ED) with the same problems. The patient described the pain in his or her stomach as colicky. He had an upper respiratory tract infection three weeks before, during which he started to have these symptoms. However, there were no further symptoms, such as nausea, vomiting, or GI bleeding. He received medical attention for his condition, which immediately got better. The ED staff investigated the reason and ran a contrast-enhanced CT abdomen, but all of the results were negative. His serum creatinine level was somewhat high at the time. The patient's abdomen was quite painful during a clinical examination. He had a large, crimson, raised rash that was purpuric in colour that covered both of his hips and lower limbs. Up to the forearms, the upper limbs were also engaged.

All of the patient's lab tests, including the CBC, creatinine, serum C3, C4, and rheumatoid factor, were normal. Positive occult blood was discovered in the patient's stool, and CRP was discovered to be high.

Using a combination of the aforementioned medical symptoms and tests, the patient's condition was determined to be abdominal angina. The symptoms were consistent with the usual pattern: purpuric rash, stomach discomfort, involvement of the kidneys, occult blood in the stool, all of which were preceded by a confirmed upper respiratory tract infection (URTI). The patient was eventually diagnosed with immune-mediated IgA vasculitis (also known as Henoch-Schonlein purpura) and received treatment as a result.

In the parts that follow, we'll look at how the patient was identified, treated, and managed appropriately to preserve his life. As a result, this case will serve as crucial study material for all interested physicians and doctors, enabling them to prepare for the possibility that they could face a patient like this in a clinical context. The example explains how uncertainties should be handled when facing such perplexing instances by thoroughly examining all the factors that contributed to the patient's final diagnosis.

Author(s) Details:

Mohamed Eltaieb Ali,

Department of Internal Medicine, Madinat Zayed Hospital, UAE.

Ashraf Alakkad,

Department of Internal Medicine, Madinat Zayed Hospital, UAE.

Please see the link here: https://stm.bookpi.org/CPMS-V1/article/view/7326