RT Book, Section
A1 Bundy, Nicole C.
A2 Dean, Steven M.
A2 Satiani, Bhagwan
A2 Abraham, William T.
SR Print(0)
ID 1105292326
T1 ANCA-NEGATIVE SMALL VESSEL VASCULITIS
T2 Color Atlas and Synopsis of Vascular Diseases
YR 2015
FD 2015
PB McGraw-Hill Medical
PP New York, NY
SN 9780071749541
LK accesscardiology.mhmedical.com/content.aspx?aid=1105292326
RD 2024/04/18
AB A  39-year-old,  previously  healthy  man  presented  to  rheumatology  clinic  with  6  days  of  a  progressively  severe  rash  on  his  lower  legs  and  pain  in  his  knees  and  ankles.  He  denied  recent  upper  respiratory  or  other  infection.  He  took  no  medications.  He  was  afebrile,  and  vital  signs  were  normal.  Physical  examination  revealed  a  rash  on  the  feet  and  lower  legs  characterized  by  palpable  purpura  with  several  large  areas  of  confluence  (Figure  77-1).  His  knees  were  tender,  and  the  ankles  were  tender  and  swollen;  the  remainder  of  the  joint  examination  was  unremarkable.  The  cardiopulmonary,  abdominal,  and  neurologic  examinations  were  normal.  Laboratory  values  were  remarkable  for  creatinine  of  1.4  and  a  spot  urine  protein  or  creatinine  ratio  of  1.9.  Chemistries,  including  liver  functions,  and  a  complete  blood  count  (CBC)  were  normal.  Antineutrophil  cytoplasmic  antibody  (ANCA)  studies  were  negative.  A  renal  biopsy  was  performed  and  confirmed  a  diagnosis  of  Henoch-Schönlein  purpura  (HSP)  (Figures  77-2  and  77-3).