Question:
A 6-year-old boy presents with abdominal pain, palpable purpura over the lower limbs, and arthralgia. Urinalysis shows microscopic hematuria. The clinical picture is consistent with which diagnosis?
A 6-year-old boy presents with abdominal pain, palpable purpura over the lower limbs, and arthralgia. Urinalysis shows microscopic hematuria. The clinical picture is consistent with which diagnosis?
Show Hint
Mandatory criterion for HSP: Palpable purpura (non-thrombocytopenic) with lower extremity/buttock distribution. Platelet count is always normal or elevated!
Updated On: Sep 3, 2026
- Hemolytic uremic syndrome
- Henoch-Schönlein purpura
- Dengue fever
- Inflammatory bowel disease
Show Solution
Verified By Collegedunia
The Correct Option is B
Solution and Explanation
Concept:
Henoch-Schönlein purpura (HSP), also recognized as IgA vasculitis, is the most common systemic small-vessel vasculitis in childhood.
It is characterized pathologically by leukocytoclastic vasculitis with predominant IgA-dominant immune complex deposition in small vessels of the skin, gastrointestinal tract, joints, and kidneys.
Explanation:
• The EULAR/PRINTO/PRES consensus criteria require the presence of palpable purpura (mandatory criterion, predominantly on dependent areas such as buttocks and lower extremities) without thrombocytopenia or coagulopathy, PLUS at least one of the following:
1. Diffuse colicky abdominal pain (often complicated by intussusception)
2. Arthritis or arthralgia (acute onset, non-migratory, non-deforming)
3. Renal involvement (hematuria and/or proteinuria)
4. Biopsy showing predominant IgA deposition
• The provided immunofluorescence image typically demonstrates prominent mesangial or capillary wall IgA deposition within the renal glomerulus or dermal venules.
• Hemolytic Uremic Syndrome (HUS) is characterized by the classic triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury, usually following bloody diarrhea without palpable purpura.
• Dengue fever presents with acute febrile illness, retro-orbital pain, severe myalgia, thrombocytopenia, and petechial (non-palpable) rash.
Final Answer:
The classic tetrad of palpable purpura, colicky abdominal pain, arthralgia, and renal involvement (microscopic hematuria) is diagnostic of Henoch-Schönlein Purpura (IgA Vasculitis).
Henoch-Schönlein purpura (HSP), also recognized as IgA vasculitis, is the most common systemic small-vessel vasculitis in childhood.
It is characterized pathologically by leukocytoclastic vasculitis with predominant IgA-dominant immune complex deposition in small vessels of the skin, gastrointestinal tract, joints, and kidneys.
Explanation:
• The EULAR/PRINTO/PRES consensus criteria require the presence of palpable purpura (mandatory criterion, predominantly on dependent areas such as buttocks and lower extremities) without thrombocytopenia or coagulopathy, PLUS at least one of the following:
1. Diffuse colicky abdominal pain (often complicated by intussusception)
2. Arthritis or arthralgia (acute onset, non-migratory, non-deforming)
3. Renal involvement (hematuria and/or proteinuria)
4. Biopsy showing predominant IgA deposition
• The provided immunofluorescence image typically demonstrates prominent mesangial or capillary wall IgA deposition within the renal glomerulus or dermal venules.
• Hemolytic Uremic Syndrome (HUS) is characterized by the classic triad of microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury, usually following bloody diarrhea without palpable purpura.
• Dengue fever presents with acute febrile illness, retro-orbital pain, severe myalgia, thrombocytopenia, and petechial (non-palpable) rash.
Final Answer:
The classic tetrad of palpable purpura, colicky abdominal pain, arthralgia, and renal involvement (microscopic hematuria) is diagnostic of Henoch-Schönlein Purpura (IgA Vasculitis).
Was this answer helpful?
0
0
Top NEET SS Paediatrics Questions
- A 2-year-old child presents with persistent fever for 4 days. Examination shows conjunctival injection and periungual desquamation, but criteria for complete Kawasaki disease are not met. You plan to evaluate for incomplete Kawasaki disease as per AHA guidelines. Which of the following investigations is NOT routinely recommended in this evaluation?
- A 27-year-old pregnant woman with systemic lupus erythematosus (SLE) is concerned about the risk of congenital heart block in her fetus due to anti-Ro/SSA antibodies. Which of the following medications is not recommended antenatally to prevent cardiac manifestations of neonatal lupus?
- A 2-week-old infant presents with a photosensitive annular erythematous rash on the face. ECG reveals complete heart block. Which is the most likely diagnosis?
- A 10-year-old child presents with arthritis involving the wrist and first MCP joint. Examination shows nail pitting. Which of the following is the most likely diagnosis?
- A 14-year-old girl with SLE presents with edema and nephrotic-range proteinuria. Renal biopsy shows diffuse thickening of the glomerular basement membrane without proliferative lesions. This corresponds to which class of lupus nephritis?
View More Questions
Top NEET SS Pediatric Rheumatology Questions
- A 2-year-old child presents with persistent fever for 4 days. Examination shows conjunctival injection and periungual desquamation, but criteria for complete Kawasaki disease are not met. You plan to evaluate for incomplete Kawasaki disease as per AHA guidelines. Which of the following investigations is NOT routinely recommended in this evaluation?
- A 27-year-old pregnant woman with systemic lupus erythematosus (SLE) is concerned about the risk of congenital heart block in her fetus due to anti-Ro/SSA antibodies. Which of the following medications is not recommended antenatally to prevent cardiac manifestations of neonatal lupus?
- A 2-week-old infant presents with a photosensitive annular erythematous rash on the face. ECG reveals complete heart block. Which is the most likely diagnosis?
- A 10-year-old child presents with arthritis involving the wrist and first MCP joint. Examination shows nail pitting. Which of the following is the most likely diagnosis?
- A 14-year-old girl with SLE presents with edema and nephrotic-range proteinuria. Renal biopsy shows diffuse thickening of the glomerular basement membrane without proliferative lesions. This corresponds to which class of lupus nephritis?
View More Questions
Top NEET SS Questions
- A liver transplant patient presents with diarrhoea, colitis, a total leukocyte count of 1800, and a positive blood CMV PCR. What is the next step in management?
- A 32-year-old male recovering from dengue fever initially showed clinical improvement but now presents with recurrence of high-grade fever, fatigue, and pancytopenia on day 10 of illness. He is hemodynamically stable with no bleeding manifestations. Which of the following investigations should be performed first to evaluate the cause of relapse and cytopenia?
- A 48-year-old man with chronic hepatitis C infection is being evaluated for risk factors associated with progression of liver disease. He has a 20-year history of infection, drinks alcohol occasionally, and has a high serum HCV RNA viral load. Which of the following factors is not associated with an increased risk of progression of liver disease in chronic HCV infection?
- A 28-year-old veterinary worker who previously received a full 3-dose pre-exposure rabies vaccination series is bitten by a stray dog while handling an animal in the clinic. The wound is cleaned immediately. What is the most appropriate post-exposure management?
- A 42-year-old patient undergoing chemotherapy for acute myeloid leukemia develops neutropenia (ANC $<$ 500) and is treated with broad-spectrum antibiotics. After initial recovery of neutrophil counts (ANC = 1500), he again develops high-grade fever and right upper quadrant abdominal pain. Imaging shows multiple small hypodense lesions in the liver and spleen. What is the most likely diagnosis?
View More Questions