A 5-year-old boy presents with palpable purpuric rash over both lower limbs and buttocks, colicky abdominal pain, and swollen painful knee joints. He has mild proteinuria and microscopic hematuria. What is the most likely renal diagnosis?

• A Henoch-Schonlein purpura (IgA vasculitis) nephritis ✓
• B Polyarteritis nodosa
• C Wegener granulomatosis (Granulomatosis with polyangiitis)
• D Systemic lupus erythematosus

Explanation

Henoch-Schonlein purpura (IgA vasculitis) is characterized by the tetrad of palpable purpura (over lower limbs and buttocks), arthralgia/arthritis (knees and ankles), abdominal pain, and renal involvement (hematuria and proteinuria). It is the most common systemic vasculitis in children. PAN does not cause purpura. GPA presents with upper airway and pulmonary involvement. SLE would have positive ANA and anti-dsDNA.

Reference: Nelson Textbook of Pediatrics, 21st ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.