Huy initially visited a hospital where he was diagnosed with cellulitis in his right leg. After taking medication for three days without improvement, he sought further examination at Tam Anh General Hospital Ho Chi Minh City. Associate Professor Doctor Vu Huy Tru, Head of the Pediatrics Department, reported that upon admission, Huy experienced intermittent abdominal pain and appeared pale. Blood tests revealed elevated white blood cells, high inflammatory markers such as C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR), and a positive anti-streptolysin O antibody test. An ultrasound confirmed subcutaneous tissue edema in the right lower leg, with no signs of venous thrombosis.

Associate Professor Tru diagnosed Huy with Henoch-Schonlein purpura (HSP), a form of systemic vasculitis caused by immunoglobulin A (IgA) deposition in blood vessel walls. This condition affects approximately 8-20 children per 100,000 annually and is more common in boys than girls. It can damage various organs, including the skin, joints, gastrointestinal tract, and kidneys. While the exact cause remains unknown, HSP often follows acute infections and is prevalent during non-summer months.

Currently, there is no specific cure for Henoch-Schonlein disease; treatment primarily focuses on managing symptoms and close monitoring. Associate Professor Tru emphasized that without proper diagnosis and timely intervention, affected children face risks of hematuria, proteinuria, and even kidney failure.

Huy received intravenous antibiotics, combined with pain relievers, antihistamines, and digestive support medication. Doctors also administered corticosteroids to reduce inflammation and alleviate his abdominal pain, joint swelling, and purpuric rash. Huy's urine output, rash, and leg swelling were closely monitored. He was also advised to elevate his legs while lying down and engage in light exercise to reduce swelling.

After 10 days of treatment, the purple skin rash on Huy's skin gradually faded, his abdominal pain resolved, and his leg pain subsided. A Doppler ultrasound of the leg veins showed no thrombosis, ruling out the risk of embolism due to blood clots. However, Huy needs continued monitoring of his kidney function, as Henoch-Schonlein disease can cause late complications, the most dangerous being kidney failure.

Doctor CKII Duong Anh Dung, Pediatrics Department, Tam Anh General Hospital Ho Chi Minh City, examining Huy before discharge. Photo: Hospital provided

Following discharge, Huy was scheduled for regular follow-up appointments to monitor the purpuric rash, kidney function, and urine.

According to Associate Professor Tru, Henoch-Schonlein can recur in some children, often within a few weeks to several months after the initial episode. Parents should monitor for signs such as recurrent purpuric rash, abdominal pain, joint swelling, or changes in urine, and seek early medical attention if they appear.

In the early stage of the disease, children typically develop purple skin rashes on their legs or buttocks that do not blanch when pressed. In the advanced stage, children may experience abdominal pain, vomiting, bloody stools, or joint swelling. These symptoms can easily be mistaken for appendicitis, dengue fever, or certain hematological or kidney diseases.

Minh Tam

*Character's name has been changed