A 6-year-old boy presents with lower extremity palpable non-thrombocytopenic purpura, colicky abdominal pain, arthralgia, and microscopic hematuria. Platelet count is normal at 320,000/mm3. What is the diagnosis?
Answer and explanation
Correct answer: C. Henoch-Schönlein purpura (IgA vasculitis)
- Step 1: Henoch-Schönlein purpura is the most common systemic vasculitis of childhood, characterized by IgA immune complex deposition in small vessels.
- Step 2: The classic tetrad includes palpable purpura (predominantly on buttocks and lower extremities), arthralgia, abdominal pain, and renal involvement (hematuria/proteinuria) with normal platelets.
- Step 3: ITP presents with thrombocytopenia without systemic inflammatory signs.
Answer
Henoch-Schönlein purpura (IgA vasculitis).
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