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Recurrent euptions with HENOCH SCHNOLIEN PURPURA. Treatment course?

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I have a teenage son, 19 years old, (height 183 cms, weight 90 kgs) who has been diagnosed with Henoch Schnolien Purpura a week ago. It started withpain abdomen on 21 oct. He was treated for ac gastritis for 3 days when he had a severe pain abdomen episode on 23 oct. was admitted and all tests carried out. platelet counts were normal. LFT- normal, TLC- mild leucocytosis (11,600) with 85 polymorphs. pancreatic tests normal (amylase 65). GI endoscopy done on 27 oct showed reflux esophgaitis. pain episodes continued. On 27oct he developed purpural rash over lower limbs and arms. with arthiritis of ankles on 30 oct. he was put on on steroids, prednisolone 40 +20 mg or last 3 days, but has had a fresh crop of purpura with pain abdomen.
other inv - IGA - mildly raised, ANA and ANCA - negative. ASO titre- mildly raised, USG abd - NAD, xray abdomen plain supine and erect- nad. repeat GI endoscopy on 01 nov - purpural rash on antrum of stomach and at duodenal junction. renal parameters normal. no hematuria detected. no melena or vomiting. no signs of intsusseption

addl medicines being give tab pantoprazole, inj tramadole (50 mg, SOS), Inj pcm 1gm, sos and mucaine gel

is the process of recurrent eruptions with pain abdomen a known phenomenon?
what should be the further course of treatment?
how long should the process continue?

Category: Dermatologist

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Category: Cosmetic and Plastic Surgeon
 21 Doctors Online

Hello,

Thanks for posting your query at DoctorSpring.com

I can understand your concern.

Thanks for the detailed information that you have provided.

Recurrent Abdominal pain with rash over a period of several weeks is the way the disease progresses. It usually goes on for a few weeks and then it usually resolves. But there could be relapses in the future.



The treatment is mainly supportive in terms of controlling the pain. Oral corticosteroids are given in cases of abdominal pain.

He is under the correct treatment. It will gradually resolve.

Please let me know if you have any queries .
Regards.



Patient replied :

What is the best medication for resolving the episodes of pain abdomen? It is colicky in nature and usually comes sometimes after food. Is tramadol good? He doesnt respond very well tp tramadol though and the pain takes around 2 hrs to settle down. Doctor says that in case we want to avoid too many painkillers, putting a fentanyl patch could help


Hello,
Sorry for the exceptional delay in the reply.
I won't advise Fentanyl ( Duragesic patch ) for a short term use, because the potential for side effects such as diarrhea, headache, dyspnea are common. I don't mean to say it is not a safe option, but compared to tramadol it has higher potential for side effects.
As i mentioned Tramadol, and oral corticosteroids will be the best option for him.
Hopefully it will resolve soon.
Wish his speedy recovery!
Regards.


Dr. Kruti Jobanputra Banodkar
Category: Cosmetic and Plastic Surgeon
Experience: 
Diploma in Dermatology - Royal College Of Physicians & Surgeons Of Glasgow, UK , 2010
Residency - DNB, Dermatology -  K.J Somaiya Hospital, Mumbai, 2009
Medical School & Internship - MBBS - Dr. D . Y . Patil Medical College, Mumbai, 2004
Dr. Kruti Jobanputra Banodkar and 4 other Medical Specialists are ready to help you

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