Acute hemorrhagic edema of infancy

Abstract

Acute hemorrhagic edema of infancy is a rare form of leukocytoclastic vasculitis. Mostly it appears under three years of age and is characterized by purpuric skin lesions, fever and edema. A three years-old boy, who has cough and coryzea was admitted to our clinic for fever and red spots on legs and arms. In physical examination; ecimotic skin lesions on right ear, face, arms, dorsal of the hands, buttocks, legs and dorsal of the feet were found. In the laboratory tests acute phase reactants were elevated and blood coagulation tests were in normal range. Hepatit A,B,C and TORCH markers were negative. Punch biopsy obtained from gluteal area showed leukositoclastic vasculity. Focal fibrinogen accumulation was detected by immun fluorescent microscopy. Regression on lesions was not observed despite supportive therapy, so prednisolone (1 mg/kg/day) therapy was started. On the third day of the steroid therapy, complete recovery was achived.

Keywords

• Hemorrhagic edema of infancy , leukocytoclastic vasculitis, steroid therapy

Bebeklik dönemi akut hemorajik ödemi

Abstract

Akut infantil hemorajik ödem lökositoklastik vaskülitin bir formu olup, daha çok üç yaş altı çocuklarda ateş, ödem ve purpurik deri lezyonları ile karakterizedir. Üç yaşında öksürük ve soğuk algınlığı olan erkek çocuk kliniğimize bacak ve kollarında kırmızı renkli döküntü, ateş nedeni ile başvurdu. Fizik incelemede sağ kulak üstünde, yüzünde, kollarında ve ekstremitelerinde ekimotik lezyonlar bulundu. Laboratuvar sonuçlarında akut faz reaktanları pozitif, koagulasyon testleri ise normal idi. Hepatit A,B,C ve TORCH belirteçleri negatif idi. Gluteal bölgeden alınan punch biyopsi sonucu lökositoklastik vaskülit ile uyumlu ve immünfloresan incelemede lokal fibrinojen birikimi tespit edildi. Destek tedavisine rağmen lezyonlarında gerileme gözlenmeyen hastaya bu nedenle 1mg/kg/gün prednizolon tedavisi başlandı. Tedavinin üçüncü gününde lezyonlar tamamen düzeldi

Keywords

• infantil hemorajik ödem, lökositoklastik vaskülit, steroid tedavisi

References

1. Shah D, Goraya J, Poddar B, Parmar V, Acute Infantile Hemorrhagic Edema and Henoch- Schonlein Purpura Overlap in a Child. Pediatr Dermatol 2002;19:92-3.
2. Odom RB, James WD, Berger TG: Andrew’s Disease of the Skin Clinical Dermatology. Ninth edition. Philadelphia, WB Saunders Company, 2000;1035-1036.
3. Tınaztepe K, Güçer Ş. Lökositoklastik vaskülit. Katkı Pediatri Dergisi 1995;16:152-164.
4. Beselga E, Drolet BA, Esterlag NB. Purpura in infants and childiren. J Am Acad Dermatol 1997;37:673-674.
5. Legrain V, Lejean S, Taieb A, Guillard JM, Battin J, Malaville J. Infantile Acute Hemorrhagic Edema of skin: study of ten cases. J Am Acad Dermatol 1991;24:17-22.
6. Millard T, Haris A, McDonald D. Acute Infantile Hemorrhagic Edema. J Am Acad Dermatol 1999;41:837-839.
7. Cunningham BB, Caro WA, Eramo LR. Neonatal acute hemorrhagic edema of childhood: case report and review of the English-language literature. Pediatr Dermatol 1996;13: 39-44.