Acute hemorrhagic edema of infancy

Abstract

Acute hemorrhagic edema of childhood, also called acute hemorrhagic edema of infancy (AHEI) or Finkelstein-Seidlmayer disease is a vasculitis of small blood vessels. The etiology of the disease is unknown, but various reports in the literature indicate precursor triggers including a preceding infectious disease. This article presents a clinical observation of an 8-month-old boy with ecchymotic skin lesions on legs and ears as well as genital edema, with a history of mild upper respiratory infection two weeks before referral. Laboratory findings were normal. After a few days, he was discharged without particular treatment. Despite the low prevalence of this disease, it is important to consider it during examinations due to the clinical nature of the diagnosis. Based on clinical and laboratory findings, a diagnosis of AHEI was made. We decided not to perform any therapy, and after about two weeks lesions had a self-limited resolution. The child was monitored clinically for about six months, and he did not present any relapse of the disease during the follow-up period. This patient was admitted to the hospital, underwent important laboratory tests, and was evaluated by multiple subspecialty services prior to diagnosis. While keeping in mind more worrisome diagnoses, physicians should consider the diagnosis of AHEI in well-appearing young children with purpuric lesions on the face and ears and non-pitting edema of the extremities. Awareness and early recognition of AHEI may prevent hospital admission, invasive workup, and parental and physician concern. Key words: acute hemorrhagic edema of infancy, Finkelstein-Seidlmayer disease, vasculitis