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Nejm image challenge10312013-1

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Nejm image challenge10312013-1

  1. 1. Image Challenge Q: What is the diagnosis in this patient who had abdominal pain? 1. Familial Mediterranean fever 2. Henoch-Schönlein purpura 3. Meningococcemia 4. Polyarteritis nodosa 5. Rocky Mountain spotted fever
  2. 2. Image Challenge Q: What is the diagnosis in this patient who had abdominal pain? Answer: 2. Henoch-Schönlein purpura Skin biopsies revealed leukocytoclastic vasculitis with IgA deposition, which is consistent with IgA vasculitis (Henoch-Schönlein purpura). The patient was treated with high-dose glucocorticoids including pulse therapy, which were tapered successfully after cyclosporine was added to the treatment. Henoch-Schönlein purpura, a systemic small-vessel vasculitis, causes palpable purpura in the lower extremities, abdominal pain, arthralgia, and glomerulonephritis.

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