Abstract
Henoch-Schönlein purpura (HSP) is a systemic disorder characterized by leukocytoclastic vasculitis involving the capillaries and by the deposition of IgA immune complexes. An association between HSP and atypical bacteria is uncommon in children. Here we report three cases of children, aged 5, 4 and 16 years, who were diagnosed with HSP associated with Mycoplasma pneumoniae or Chlamydia pneumoniae infection. In all presented cases, persistent cutaneous manifestations and abdominal pain were resistant to antibiotics and corticosteroids, but resolved during 48 h after the introduction of dapsone. No adverse effects of treatment were observed. Dapsone, a sulphone with an anti-inflammatory activity, showed remarkable therapeutic efficacy against rash and gastrointestinal symptoms in children with HSP. Its administration should be considered particularly in persistent cutaneous form of HSP.
Highlights
Henoch-Schönlein purpura (HSP) is a small vessel vasculitis resulting from immunoglobulin A (IgA)-mediated inflammation
We report three cases of HSP associated with atypical bacterial infections - Mycoplasma pneumoniae and Chlamydia pneumoniae - with relapsing cutaneous manifestations and abdominal pain, which were alleviated by dapsone treatment
Dapsone should be considered for treatment of persistent purpura and abdominal pain in HSP especially in patients without renal involvement, such as in our three cases. This is a report of three children with HenochSchönlein purpura (HSP) underlined by infection with Mycoplasma pneumoniae or Chlamydia pneumoniae, who presented with persistent rash and gastrointestinal symptoms resistant to standard treatment
Summary
Henoch-Schönlein purpura (HSP) is a small vessel vasculitis resulting from immunoglobulin A (IgA)-mediated inflammation. It is the most common acute systemic vasculitis of childhood mainly affecting skin, gastrointestinal tract, joints and kidneys. Some patients suffer from chronic cutaneous form of HSP and recurrent abdominal pain. Henoch-Schönlein purpura (HSP) is a systemic disorder characterized by leukocytoclastic vasculitis involving the capillaries and by the deposition of IgA immune complexes. Persistent cutaneous manifestations and abdominal pain were resistant to antibiotics and corticosteroids, but resolved during 48 h after the introduction of dapsone. A sulphone with an anti-inflammatory activity, showed remarkable therapeutic efficacy against rash and gastrointestinal symptoms in children with HSP. Its administration should be considered in persistent cutaneous form of HSP
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