Abstract:Description of two cases of acute haemorrhagic oedema (purpura en cocarde with oedema) in infants with its clinical signs: oedema occurring distally, ecchymotic purpura en cocarde, associated generally with rhinopharyngeal manifestations. Histology: pericapillaritis with diapedesis and discrete inflammation is not pathognomonic.
“…Using the mentioned research technique, we were able to accumulate 155 reports in 6 languages 1-4,10-160 : 67 reports in English*; 33 in Spanish y ; 24 in French z ; 16 in Italian § ; 10 in German jj ; and 5 in Portuguese. 76,128,136,140,151 Each of the reports contained one case (113 reports); 2 cases (16 reports); 3 cases (7 reports); 4 cases (5 reports); 5 cases (6 reports); or 6 or more cases (8 reports), for a total of 287 patients (three patients reported more than once in the literature were considered only once 12,16,20,21,49,85 ).…”
“…Using the mentioned research technique, we were able to accumulate 155 reports in 6 languages 1-4,10-160 : 67 reports in English*; 33 in Spanish y ; 24 in French z ; 16 in Italian § ; 10 in German jj ; and 5 in Portuguese. 76,128,136,140,151 Each of the reports contained one case (113 reports); 2 cases (16 reports); 3 cases (7 reports); 4 cases (5 reports); 5 cases (6 reports); or 6 or more cases (8 reports), for a total of 287 patients (three patients reported more than once in the literature were considered only once 12,16,20,21,49,85 ).…”
“…Se ha descrito la presencia de factores gatillantes hasta en el 75% de los casos 9 . Dentro de éstos destacan: infecciones virales (infecciones respiratorias altas, otitis media 10,11 , conjuntivitis 6,12 ), bacterianas (infecciones estreptocócicas [13][14][15] , tuberculosis pulmonar 5 , bronconeumonía 7 o infecciones del tracto urinario), vacunaciones (sarampión, difteria, pertussis, tétanos o en combinación) e hipersensibilidad a medicamentos (penicilina, cefalosporinas, trimetoprim sulfametoxazol, paracetamol y otros).…”
Este trabajo cumple con los requisitos sobre consentimiento /asentimiento informado, comité de ética, financiamiento, estudios animales y sobre la ausencia de conflictos de intereses según corresponda.
“…Visceral involvement is rare (2)(3)(4)(5). HSP, in contrast, more often shows visceral involvement and renal sequelae (1 [1][2][3][4][5][6][7][8][9][10][11][12].…”
Four patients with acute hemorrhagic edema (AHE) of childhood are presented. Two patients had associated pulmonary tuberculosis. AHE of childhood is a benign condition, characterized by inflammatory edema and ecchymotic purpura in a target or cockade pattern. Histology of the skin lesions shows typical leucocytoclastic vasculitis and the condition has therefore been considered a variant of HenochSchonlein purpura (HSP). However, because of its benign course, AHE should be considered as a separate entity.Acute hemorrhagic edema (AHE) of childhood, first described by Snow (1) in 1913, was considered a variant of Henoch-Schonlein purpura (HSP) because the condition presents in childhood with purpuric skin lesions and shows leucocytoclastic vasculitis on histology. Recently it has been recognized as a separate entity (2,3).Four patients with AHE are described, with an overview of the condition. Two of the patients had associated pulmonary tuberculosis. The possible effect of this and other antigens on the immune responses is discussed.
PATIENT 1A 9-month-old boy presented with generalized target lesions and limb and facial edema of 4 days duration (Fig. 1). He had a history of a preceding upper respiratory tract infection and chronic arthropod exposure. Eye sepsis and an episode of occult blood-positive diarrhea complicated the presentation.Urine examination and streptococcal serology were normal. A chest roentgenogram showed right hilar lymphadenopathy with bronchitic change. A skin biopsy specimen demonstrated a leucocytoclastic vasculitis. Direct immunofluorescence was negative. Immunologic Observatory 7925, Cape, South Africa. workup revealed a persistent anemia and leucocytosis with normal serum electrophoresis, complement, and immunoglobulin profiles.The patient had recurrences of his skin lesions over the next 15 months, despite numerous and varied courses of antibiotics given for associated infections. The morphology of the skin lesions during these relapses varied from purpura, ecchymotic plaques, and erythema multiforme-like lesions to concentric rings of purpuric erythema, characteristic of the cockade lesions of AHE (Fig. 2). The lesions resolved spontaneously, with each relapse leaving no scars.Persistent chest roentgenogram changes, profuse sweating, and poor weight gain over the 15 month period suggested underlying pulmonary tuberculosis. His tuberculin test was strongly positive. Supervised antituberculosis treatment (isoniazid 100 mglday; rifampicin 100 mglday, and pyrazinamide 300 mglday) had little effect on the patient's skin condition. Dapsone, 25 mg daily, was added to the antituberculous treatment regimen after 5 months and the skin lesions of AHE resolved. Classic skin signs of papular urticaria persisted for several months thereafter, resolving spontaneously.
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