Central Nervous System Involvement in Henoch-Schonlein Purpura in Children and Adolescents
Central nervous system (CNS) involvement in Henoch-Schonlein purpura (HSP) is rare but poses diagnostic difficulties. The aim of the study was to establish the frequency of CNS involvement in HSP, to analyze its clinical characteristics and do a literature review. Medical files of patients with HSP...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/2017/5483543 |
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| author | Iliyana H. Pacheva Ivan S. Ivanov Krastina Stefanova Elena Chepisheva Lyubov Chochkova Dafina Grozeva Angelina Stoyanova Stojan Milenkov Penka Stefanova Anna Petrova |
| author_facet | Iliyana H. Pacheva Ivan S. Ivanov Krastina Stefanova Elena Chepisheva Lyubov Chochkova Dafina Grozeva Angelina Stoyanova Stojan Milenkov Penka Stefanova Anna Petrova |
| author_sort | Iliyana H. Pacheva |
| collection | DOAJ |
| description | Central nervous system (CNS) involvement in Henoch-Schonlein purpura (HSP) is rare but poses diagnostic difficulties. The aim of the study was to establish the frequency of CNS involvement in HSP, to analyze its clinical characteristics and do a literature review. Medical files of patients with HSP admitted at the Department of Pediatrics, Plovdiv, were studied retrospectively for a five-year period (2009–2013). Diagnosis was based on the American College of Rheumatology criteria. Out of 112 children with HSP 1 case (0.9%) had CNS involvement presenting as Posterior Reversible Encephalopathy Syndrome (PRES), which may be a result of CNS vasculitis or arterial hypertension. It was an 8-year-old girl with atypical HSP which started with abdominal pain requiring surgery. On the third day after the operation a transient macular rash and arterial hypertension appeared, followed by visual disturbances, hemiconvulsive epileptic seizures, postictal hemiparesis, and confusion. Head CT showed occipital hypodense lesions and MRT-T2 hyperintense lesion in the left occipital lobe. The patient experienced a second similar episode after 2 weeks when palpable purpura had also appeared. Neurological symptoms and MRI resolved completely. HSP can be an etiological factor for PRES in childhood. Although PRES is a rare complication of HSP, clinicians must be aware of it and avoid diagnostic and therapeutic delays. |
| format | Article |
| id | doaj-art-61752a9583a34275a8313ac40c43e77e |
| institution | Kabale University |
| issn | 2090-6803 2090-6811 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pediatrics |
| spelling | doaj-art-61752a9583a34275a8313ac40c43e77e2025-02-03T01:03:06ZengWileyCase Reports in Pediatrics2090-68032090-68112017-01-01201710.1155/2017/54835435483543Central Nervous System Involvement in Henoch-Schonlein Purpura in Children and AdolescentsIliyana H. Pacheva0Ivan S. Ivanov1Krastina Stefanova2Elena Chepisheva3Lyubov Chochkova4Dafina Grozeva5Angelina Stoyanova6Stojan Milenkov7Penka Stefanova8Anna Petrova9Department of Pediatrics and Medical Genetics, Medical University-Plovdiv, Plovdiv, BulgariaDepartment of Pediatrics and Medical Genetics, Medical University-Plovdiv, Plovdiv, BulgariaDepartment of Pediatrics and Medical Genetics, Medical University-Plovdiv, Plovdiv, BulgariaDepartment of Pediatric Surgery, “St. George” University Hospital, Plovdiv, BulgariaDepartment of Pediatrics and Medical Genetics, Medical University-Plovdiv, Plovdiv, BulgariaDepartment of Pediatrics and Medical Genetics, Medical University-Plovdiv, Plovdiv, BulgariaDepartment of Pediatrics and Medical Genetics, Medical University-Plovdiv, Plovdiv, BulgariaDepartment of Pediatrics and Medical Genetics, Medical University-Plovdiv, Plovdiv, BulgariaDepartment of Pediatric Surgery, “St. George” University Hospital, Plovdiv, BulgariaDepartment of Imaging Diagnosis, “St. George” University Hospital, Medical University-Plovdiv, Plovdiv, BulgariaCentral nervous system (CNS) involvement in Henoch-Schonlein purpura (HSP) is rare but poses diagnostic difficulties. The aim of the study was to establish the frequency of CNS involvement in HSP, to analyze its clinical characteristics and do a literature review. Medical files of patients with HSP admitted at the Department of Pediatrics, Plovdiv, were studied retrospectively for a five-year period (2009–2013). Diagnosis was based on the American College of Rheumatology criteria. Out of 112 children with HSP 1 case (0.9%) had CNS involvement presenting as Posterior Reversible Encephalopathy Syndrome (PRES), which may be a result of CNS vasculitis or arterial hypertension. It was an 8-year-old girl with atypical HSP which started with abdominal pain requiring surgery. On the third day after the operation a transient macular rash and arterial hypertension appeared, followed by visual disturbances, hemiconvulsive epileptic seizures, postictal hemiparesis, and confusion. Head CT showed occipital hypodense lesions and MRT-T2 hyperintense lesion in the left occipital lobe. The patient experienced a second similar episode after 2 weeks when palpable purpura had also appeared. Neurological symptoms and MRI resolved completely. HSP can be an etiological factor for PRES in childhood. Although PRES is a rare complication of HSP, clinicians must be aware of it and avoid diagnostic and therapeutic delays.http://dx.doi.org/10.1155/2017/5483543 |
| spellingShingle | Iliyana H. Pacheva Ivan S. Ivanov Krastina Stefanova Elena Chepisheva Lyubov Chochkova Dafina Grozeva Angelina Stoyanova Stojan Milenkov Penka Stefanova Anna Petrova Central Nervous System Involvement in Henoch-Schonlein Purpura in Children and Adolescents Case Reports in Pediatrics |
| title | Central Nervous System Involvement in Henoch-Schonlein Purpura in Children and Adolescents |
| title_full | Central Nervous System Involvement in Henoch-Schonlein Purpura in Children and Adolescents |
| title_fullStr | Central Nervous System Involvement in Henoch-Schonlein Purpura in Children and Adolescents |
| title_full_unstemmed | Central Nervous System Involvement in Henoch-Schonlein Purpura in Children and Adolescents |
| title_short | Central Nervous System Involvement in Henoch-Schonlein Purpura in Children and Adolescents |
| title_sort | central nervous system involvement in henoch schonlein purpura in children and adolescents |
| url | http://dx.doi.org/10.1155/2017/5483543 |
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