QuestionSBA
QuestionChoice
This is incorrect. Although an important differential diagnosis to consider, it is unlikely in this case. Leukaemia can present with a petechial rash and raised inflammatory markers, however a raised white cell count and pancytopenia are also likely to be present on a full blood count.
10027520
e
Leukaemia
QuestionChoice
This is incorrect. This would usually not present with abdominal pain or arthritis and is often associated with thrombocytopenia.
10027518
c
Immune thrombocytopenic purpura
QuestionChoice
This is incorrect. Although presenting with a rash of a similar nature and raised inflammatory markers, meningitis would usually present with neck stiffness, photophobia and fever. On examination Brudzinski's and Kernig's signs may be present.
10027517
b
Meningitis
QuestionChoice
This is the correct answer. Henoch-Schonlein Purpura (HSP) is a small vessel vasculitis mediated by IgA. It mainly affects the skin, gastrointestinal tract and the kidneys. This child is suffering from the classical symptoms of abdominal pain, arthritis and the palpable purpuric rash over the extensor surfaces of the lower limbs. Renal function will need to be monitored, and she will need to be monitored for signs of intussusception.
10027516
a
Henoch-Schonlein Purpura
QuestionChoice
This is incorrect. Although presenting with a rash of a similar nature and raised inflammatory markers, meningitis would usually present with neck stiffness, photophobia and fever. On examination Brudzinski's and Kernig's signs may be present.
10027519
d
Haemolytic Uraemic Syndrome
Concept
Chapter
2693
5986
Henoch-Schonlein Purpura
Topic
144
Dermatology
Henoch-Schonlein Purpura
17901
Picture
2312
Purpuraschoenleinhennoch2.jpeg
images/h719qq851701430385899.jpg
images/h719qq851701430385899_256.jpg
images/h719qq851701430385899_512.jpg
ZygKFQZXiXyIB1iYh4dpeEmAkRMI
Topic
144
Dermatology
A 6-year-old girl presents to A&E with a week of feeling unwell, including sore throat, reduced appetite, abdominal pain, and joint pain. The parents are concerned as she has now developed a rash that they noticed earlier in the day. They deny any diarrhoea or vomiting.

On, the patient is generally tender across her abdomen. A petechial rash is seen across the back of her legs and buttocks. Neurological examination is unremarkable.


Observations are as follows:
BP - 100/62.
HR - 89bpm.
Saturations - 98% on room air.
RR - 24.
Temperature - 37.8C.


The rash can be seen below. [lightgallery]


Blood tests show a raised CRP and IgA levels.


Which of the following is the most likely underlying diagnosis?
a