Acute hemorrhagic edema of childhood: An unusual variant of leukocytoclastic vasculitis

Edema hemorrágico agudo da infância

“…1 The occurrence of purpuric lesions on mucosae (conjunctiva and soft palate) was also described. 5,6 Visceral involvement is rare and the few cases where it was described presented mild and transitory renal alterations, as well as gastrointestinal impairment. 1 Laboratory tests are not diagnostic.…”

Acute Hemorrhagic Edema of Infancy

“…Legrain (Legrain et al, 1991) and AlSufyani (Alsufyani, 2009) reported these related causes up to %75 and %84.6 respectively. Obviously, it is difficult to attribute AHEI to an infection, drug or immunization as these are often present together; however, a few case reports have shown clearance of the first attack, as well as relapses, of AHEI after appropriate treatment of the associated infections (Dubin et al, 1990;Gonggryp & Todd, 1998;Ince et al, 1995;Morrison et al, 1999;Tomac et al, 1996). In addition, Cunningham and colleagues (Cunningham et al, 1996(Cunningham et al, , 1999 have reported a newborn with the clinical findings of AHEI.…”

“…However, cases at birth (Cunningham et al, 1996(Cunningham et al, , 1999 and over 2 years of age (Alp et al, 2009;Dubin et al, 1990;Poyrazoglu et al, 2003;Slutsky et al, 2010), with classical features of AHEI, have been reported. Also, rare cases have been reported in older children up to 60 months of age (Alp et al, 2009;Fiore et al, 2008;Legrain et al, 1991).…”

“…This probably supports the role of infections and immune complexes in the pathogenesis of AHEI. Other infections described as prodromes that have been accused in the pathogenesis are upper respiratory tract infections (Alp et al, 2009;Babic et al, 2008;Blasini et al, 2007;Caksen et al, 2002;Dubin et al, 1990;Fiore et al, 2008;Gelmetti et al, 1985;Halıcıoglu et al, 2010;Ince et al, 1995;Karremann et al, 2009;Kumar et al, 2008;Lai-Cheong JE et al, 2007;McDougall et al, 2004;Michael, 2006;Millard et al, 1999;Paradisi et al, 2001;Poyrazoglu et al, 2003;Saraclar et al, 1990), pharyngitis (Gattorno et al, 1997;Gonggryp & Todd, 1998), tonsillitis (Legrain et al, 1991;Karremann et al, 2009), otitis (Caksen et al, 2002;Crowe et al, 1998;Karremann et al, 2009;Krause et al, 1996;Lantner et al, 1996;Macea et al, 2003), conjunctivitis (Legrain et al, 1991), neck abscess, bronchopneumonia (Alp et al, 2009;Saraclar et al, 1990), bronchitis (Karremann et al, 2009), pneumococcal bacteremia (Morrison et al, 1999), pulmoner tuberculosis (Gonggryp & Todd, 1998), cellulitis (Can et al, 2006), urinary tract infections (Saraclar et al, 1990) and gastroenteritis (Caksen et al, 2002;…”

“…Additionally, failure to convincingly relate AHEI to prodromal infectious caused by group A streptococcus or Mycoplasma pneumoniae is not surprising, considering that these agents mostly cause infections in children 5 years of age or older (Jaggi & Shulman, 2006;Principi & Esposito, 2002). A wide range of medications have been reported such as anti-inflammatory and/or antipyretics including ibuprofen (Blasini et al, 2007), aspirin and paracetamol (da Silva Manzoni et al, 2004;Fiore et al, 2008;Karremann et al, 2009;Legrain et al, 1991;Poyrazoglu et al, 2003;Saraclar et al, 1990), antimicrobials including penicillins (Legrain et al, 1991;Saraclar et al, 1990), amoxicillin (Blasini et al, 2007;Gattorno et al, 1997), sultamisilin (Halıcıoglu et al, 2010), erythromycin (Krause et al, 1996), tobramycin (Blasini et al, 2007), trimethoprim-sulfomethoxazol (Poyrazoglu et al, 2003), cefaleksin (Crowe et al, 1998;da Silva Manzoni et al, 2004;), ceftriaxone (Can et al, 2006), ceftibuten (Fiore et al, 2008) and other medications such as cough syrup (Dubin et al, 1990;Gonggryp & Todd, 1998) and probiotics (Fiore et al, 2008). Vaccines have also been implicated in the pathogenesis of AHEI, including diphtheriapertussis-tetanus (Krause et al, 1996;Saraclar et al, 1990), poliomavirus vaccine (Saraclar et al, 1990), hemophilus influenza conjugated (Krause et al, 1996), measles (Gonggryp & Todd, 1998;Saray et al, 2002), rubeola (Poyrazoglu et al, 2003), …”