A child with arthritis, skin rash, abdominal pain and nephritis: searching beyond Henoch–Schönlein purpura—Questions
A 14-year-old previously healthy white female presented with complaints of arthralgias of the fingers and toes that had progressed to involve the knees, shoulders, and temporomandibular joint over the previous month. She also had an urticarial skin rash involving the buttocks area along with the upper and lower extremities. She complained of fatigue and acute shortness of breath, but denied fever or weight loss. She denied hematuria, abdominal pain, or hematochezia. The arthralgias were worse in the morning with severe intensity. She was taking ibuprofen 800 mg three times daily. The patient had no past medical history of known renal, gastrointestinal, or cardiorespiratory disease.
On admission, she was afebrile with heart rate in the 70s, normotensive, and breathing comfortably on room air. Although able to stand, she had difficulty walking due to severe joint pain. Her pupils and sclerae appeared normal. Her oral mucous membranes were moist and there was a small red...
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Conflict of interest
The authors declare that they have no conflict of interest.