Dr. Ketan H. Shah*
Practising Pediatrician, Ketan Children Hospital, Shankheshwar complex, Majura Gate Road, Surat. *
16 years/Female presented with history of recurrent rash on body with severe colicy abdominal pain and hematuria. She was non-toxic and had macular rash mainly on extremities and not on trunk or chest. She has past history of same complains for last 4 years. Her first episode was at the age of 12 years. In between, she remains absolutely normal. Episodes of rash, pain with sometimes ankle swelling and hematuria lasts for 10-15 days and then subsides with only symptomatic treatment. She was diagnosed to have HSP. Her investigations including renal profile (Bl. Urea, S. creatinine, C3 level) were normal. Her ANA, ANCA and CRP tests were negative. She does not have ongoing renal disease by confirming normal C3 in between episodes. Duodenal biopsy was done during acute stage by surgeon. Findings were suggestive of vasculitis in endoscopy and biopsy of intestinal mucosa favored leucocytoblastic vasculitis. The reason for recurrent episodes could not be found out. Other collagen vascular diseases were ruled out by normal ANA, ANCA reports.

Recurrent HSP is known entity described. Exact etiological agent may not be found. Sometimes, recurrent respiratory tract infection acts as trigger.

Treatment is symptomatic and clinician should watch for renal disease.
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