Henoch-Schonlein purpura Quiz: Ace Your Exams
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A 6-year-old boy is brought to the emergency department by his parents for evaluation of a purple rash on his buttocks and legs, intermittent colicky abdominal pain, and right ankle pain for 2 days. According to the parents, the boy had strep throat two weeks ago and began developing a purplish rash on his buttocks and legs three days ago. The patient has no significant past medical history. Temperature is 37°C (98.6°F), blood pressure is 106/62 mmHg, heart rate is 101/min, respiratory rate is 18/min, and oxygen saturation is 99% on room air. Physical examination reveals a palpable purpuric rash on the legs and buttocks. Abdominal examination is unremarkable. Range of motion of the right ankle is limited due to pain, and there is tenderness and swelling. There is no lower extremity edema. Laboratory studies are shown below. Which of the following is the best next step in management?
| Laboratory value | Result |
| Hemoglobin | 14 g/dL |
| Hematocrit | 40% |
| Leukocyte count | 9,100 /mm3 |
| Platelet count | 350,000/mm3 |
| PTT | 27 s |
| PT | 12 s |
| Serum chemistry | |
| Sodium | 142 mEq/L |
| Potassium | 4.2 mEq/L |
| Chloride | 95 mEq/L |
| Creatinine | 0.7 mg/dL |
| Urinalysis | 2+ blood, no casts, no protein |
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