Methylprednisolone Therapy in Acute Hemorrhagic Edema of Infancy

Risikesan, Jeyanthini; Koppelhus, Uffe; Steiniche, Torben; Deleuran, Mette; Herlin, Troels

doi:10.1155/2014/853038

Cited by 11 publications

(24 citation statements)

References 9 publications

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“…Sin embargo, en los últimos años, se planteó el uso de esteroides sistémicos como una alternativa para acortar el tiempo de las lesiones o en caso de compromiso sistémico, como orquitis y dolor articular. Inclusive, altas dosis de metilprednisolona (20 mg/k/día) fueron propuestas como una opción terapéutica, 10 pero no puede ser una conducta de uso rutinario, ante la evolución benigna del cuadro.…”

Section: Discussionunclassified

Edema agudo hemorrágico de la infancia. Lesiones alarmantes de un cuadro benigno. Reporte de caso

2017

Arch Argent Pediat

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Presentación de casos clínicos RESUMENSe reporta un caso de edema agudo hemorrágico de la infancia, en un lactante de 18 meses, después de un episodio de otitis media. El cuadro comenzó con máculas eritematosas en los muslos, seguidas de lesiones purpúricas en los brazos, las piernas y edema en los tobillos. Se interpretó, inicialmente, como urticaria, por lo que recibió esteroides. Sin embargo, las características clínicas fueron de edema agudo hemorrágico de la infancia, una vasculitis leucocitoclástica benigna que se presenta en niños de entre 4 y 24 meses y que se caracteriza por fiebre, máculas y lesiones purpúricas. Estas se ubican, principalmente, en la cara, los lóbulos de las orejas y las extremidades, y se asocian, muchas veces, a edema. Los diagnósticos diferenciales son eritema multiforme, urticaria, vasculitis inducida por droga, enfermedad de Kawasaki, eccema infectado, meningococcemia y maltrato infantil, algunas de ellas, con riesgo de mortalidad. El manejo es conservador, sin embargo, los esteroides podrían ser una opción terapéutica. Palabras clave: pediatría, vasculitis leucocitoclástica cutánea, esteroides. ABSTRACTWe report a case of acute hemorrhagic edema of infancy in an 18-month-old boy after an episode of otitis media. The clinical presentation begins with skin erythematous macules on the thighs, followed by purpuric lesions in arms, legs, and ankle edema. It was initially interpreted as urticaria, whereby steroids were indicated. However, the clinical feature was acute hemorrhagic edema of infancy, a benign leukocytoclastic vasculitis that occurs in children between 4 and 24 months of age and is characterized by fever, large purpuric palpable target-like skin lesions affecting the face, lobes of the ears, limbs and frequently associated with edema. Differential diagnosis includes erythema multiforme, hemorrhagic urticaria, druginduced vasculitis, Kawasaki disease, infected eczema, sepsis Edema agudo hemorrágico de la infancia. Lesiones alarmantes de un cuadro benigno. Reporte de caso Acute hemorrhagic edema of infancy: alarming lesions of a benign condition. Case report (either meningococcal or non-meningococcal) and child abuse. Some of them have risk of mortality. Management is conservative, however, steroids may be a therapeutic option.

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Section: Discussionunclassified

Edema agudo hemorrágico de la infancia. Lesiones alarmantes de un cuadro benigno. Reporte de caso

2017

Arch Argent Pediat

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“…For the treatment, supportive care has been the main approach unlike the course of steroids which did not show much improvement in the child's previous treatment. Although systemic steroid therapy has been reported to be beneficial in some case reports, with the benign course of the illness supportive treatment is considered reasonable treatment (Fiore et al, 2008;Freitas and Bygum, 2013;Risikesan et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

“…AHE diagnosis is clinically based with the skin biopsy to confirm the typical leukocytoclastic vasculitis changes (Fiore et al, 2008). Treatment is only supportive, although there are case reports of use of systemic steroid treatment (Sorensen et al, 2014;Fiore et al, 2008;Freitas and Bygum, 2013;Risikesan et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

Acute Hemorrhagic Edema with extensive truck involvement and Rhinovirus infection association

Murayshid¹

2017

Journal of Dermatology & Dermatologic Surgery

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Acute Hemorrhagic Edema (AHE) is a rare form of leukocytoclastic vasculitis with an unknown etiology. There are various possible triggers associated with the development of AHE such as Upper Respiratory Tract related infections which have been reported in the literature. A typical case of AHE is a child less than 2 years of age having the symptoms of fever, Acral Targetoid Purpura, and Edema. The course of this illness is benign with a complete resolution within few weeks. This case report involves a patient having the classical symptoms of fever, Purpura and Edema, but with an unusual extensive truncal involvement. Moreover, Rhinovirus infection testing was positive in the child's case. The presence of the virus gives a suspicion of being the possible trigger for the boy's AHE. In the previous hospital, the treatment started with steroid for a course of one week without a significant improvement which brought the patients to the Emergency department. A decision of continuing a supportive treatment led to a complete resolution. After 3 weeks the AHE symptoms were gone without any complications.

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“…A própria evolução benigna com melhora com uso de corticoterapia é um fator confirmatório do diagnóstico [7][8][9] .…”

Section: Métodounclassified

Edema agudo hemorrágico de la infancia: relato de caso y comparación con meningococcemia

Caixeta¹,

Lima²,

Cunali³

et al. 2017

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O presente trabalho tem como objetivo relatar o caso de uma criança com 1 ano e 8 meses, em mau estado geral e choque hipovolêmico, atendida na urgência com edema agudo hemorrágico da infância (EAHI), ou a sua variante: Púrpura de Schoenlein-Henoch (PHS). As informações foram obtidas por meio de revisão de prontuário, entrevista com mãe do paciente, registro fotográfico dos métodos diagnósticos ao quais o paciente foi submetido e revisão da literatura. O caso relatado e as publicações pesquisadas trazem à luz a discussão do diagnóstico de uma situação complexa que é a doença meningocócica e o EAHI em suas várias formas, bem como na terapêutica mais adequada em momento de urgência. Descritores: Púrpura de Schoenlein-Henoch; Vasculite; Meningite.This paper aims at reporting the case of a 1 year and 8 months old child who was in a bad general state, and was admitted at the emergency room while going through hypovolemic shock, with acute hemorrhagic edema of infancy (AHEI) or its variant: Henoch -Schoenlein purpura (HSP). Information was obtained through a review of medical records, an interview with the patient, a photographic register of the diagnostic methods to which the patient was submitted. A literature review was also conducted. The reported case and the publications researched bring to light and discuss the diagnosis of a complex situation, which involves the menigococcal disease and the AHEI in its various forms, also discussing the proper therapy in urgent cases. Descriptors: Schoenlein-Henoch Purpura; Vasculitis; Meningitis.El presente trabajo tiene como objetivo relatar el caso de un niño de 1 año y 8 meses, en mal estado general y shock hipovolémico, atendido en urgencia con edema agudo hemorrágico de la infancia (EAHI), o su variante: Púrpura de Schoenlein-Henoch (PHS). Las informaciones fueron obtenidas por medio de revisión de historia clínica, entrevista con la madre del paciente, registro fotográfico de los métodos diagnósticos a los cuales el paciente fue sujeto y revisión de la literatura. El caso relatado y publicaciones investigadas, traen a la luz la discusión del diagnóstico de una situación compleja que es la enfermedad meningocócica y el EAHI en sus varias formas, bien como en la terapia más adecuada en un momento de urgencia. Descriptores: Púrpura de Schoenlein-Henoch; Vasculitis; Meningitis.

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Methylprednisolone Therapy in Acute Hemorrhagic Edema of Infancy

Cited by 11 publications

References 9 publications

Edema agudo hemorrágico de la infancia. Lesiones alarmantes de un cuadro benigno. Reporte de caso

Edema agudo hemorrágico de la infancia. Lesiones alarmantes de un cuadro benigno. Reporte de caso

Acute Hemorrhagic Edema with extensive truck involvement and Rhinovirus infection association

Edema agudo hemorrágico de la infancia: relato de caso y comparación con meningococcemia

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