HSP
Vasculitis with arthralgia, abdo pain, and or renal involvement. Purpura occurs in all patients. The rash is distinctive. Urinalysis is needed - manage with analgesia. Consider steroids.
A first episode of HSP usually resolves within 4 weeks with the rash being the last symptom to go.
Joint pain usually resolves spontaneously within 72 hours and abdo pain in 24- 48 hours.
Uncomplicated abdominal pain usually resolves spontaneously within 24-48 hours
ITP
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Petechial Rash
The flow chart on this website is useful for highlighting when to investigate but this one is probably the best.
NICE say give ceftriaxone if:
petechiae start to spread
the rash becomes purpuric
there are signs of bacterial meningitis
there are signs of meningococcal septicaemia
the child or young person appears ill to a healthcare professional
A non specific viral illness is the most likely cause of the rash.
References
https://www.rcemlearning.co.uk/foamed/7-pem-rashes/
https://dontforgetthebubbles.com/henoch-schonlein-purpura-steroids-helpful-preventing-nephropathy/
https://www.rch.org.au/clinicalguide/guideline_index/HenochSchonlein_Purpura/
http://www.clinicalguidelines.scot.nhs.uk/ggc-paediatric-guidelines/ggc-guidelines/emergency-medicine/non-blanching-rash-management-in-children/
https://dontforgetthebubbles.com/itp-idiopathic-thrombocytopenia-purpura/
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