Clinical Reference Systems: Pediatric Advisor 10.0

Description

Anaphylactoid purpura (also called Henoch-Schoenlein purpura) is an illness that can involve many different organs in the body.

Anaphylactoid purpura can occur with some or all of the following symptoms:

• Rash: The rash is often located on the buttocks and legs. The rash may first look like hives, but usually it changes to purplish or brownish bruises within 1 to 2 days. There is always some rash on the ankles.
• Painful swelling of the joints: The joints most often affected by pain are the knees and ankles. The joint pain may be severe enough to make you child unable or unwilling to walk.
• Abdominal pain: If your child has severe abdominal pain or blood in his or her stools, the doctor may need to do tests to rule out other, more serious causes of these symptoms.
• Fever.
• Blood in the urine.

Cause

The cause of this illness is not completely understood. Researchers believe that there is some inflammation (swelling) in the blood vessels, which causes symptoms. The illness is often seen in children who have had a viral upper respiratory infection (a cold) a few weeks earlier. The antibodies produced by the child's body to fight the cold may contribute to development of the illness.

Reasons for Admission to the Hospital

Main complication: ________________________________________.

__ Needs IV fluids.

__ Needs IV antibiotic or other medication.

__ Other reasons: _________________________________________.

Expected Course

There is no way to predict who will get anaphylactoid purpura and there is no way to prevent it. The illness may last for several months and the symptoms may come and go during this time. The older your child is, the more likely it is that he or she will experience the symptoms again. Your child will eventually get better on his or her own. Until then, you can treat your child's symptoms.

Requirements for Discharge

• _______________________________________________________
• _______________________________________________________
• _______________________________________________________

Discharge Instructions for Home Care

• Anti-inflammatory medications

  The best and safest medication to give to help with the pain and inflammation of swollen joints is ibuprofen (for example, Advil or Motrin). Use the same dose you use to treat your child's fever. Do not use aspirin. Acetaminophen (for example, Tylenol) may help with the pain, but it will not relieve swelling and inflammation. Your child's dose of ibuprofen is ____ mg every 6 to 8 hours as needed for pain.

• Steroid medications

  Your child's doctor may prescribe a steroid medication, such as prednisone, to reduce inflammation in the intestine. The steroid may help control pain and intestinal bleeding. Your child's steroid medicine is _____________________________________.

• Fluids

  Encourage your child to drink plenty of fluids and to eat a normal diet as much as is possible.

• Other medicines

  ________________________________________________________________

  ________________________________________________________________

• Additional instructions

  _________________________________________________________________

  _________________________________________________________________

  _________________________________________________________________

Follow-up Appointment after Discharge

Most children recover from anaphylactoid purpura completely and have no further problems. Rarely, however, the kidneys can be affected. It is important for your child to see a doctor for blood pressure checks and urine tests every 1 to 2 months over the next 2 years.

___ Your child needs to be rechecked and has an appointment on _____________ at _______ with _________________________.

___ Your child needs to be rechecked in ________ days. Call your child's doctor to make an appointment.

Call Your Child's Physician IMMEDIATELY If:

• Your child's abdominal pain is getting more severe, or there is more blood in your child's bowel movements.
• Your child begins to look puffy, especially around the face or eyes.
• Your child's urine has blood in it.
• Your child is acting very sick.

Call Your Child's Physician During Office Hours If:

• You have other questions or concerns.