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Henoch-schonlein purpura: case report A 4-year-old girl developed Henoch-schonlein purpura (HSP) following administration of influenza-virus-vaccine. The girl presented to the emergency department (ED) with rash and bruising for four days. The rash initially presented on her back, and was present on her chest, arms, cheeks and spread to lower extremities two days ago. The girl was treated with unspecified antihistamines, however, her rash did not respond to the treatment. She was referred to the emergency department. Her parents did not report a history of recent fever, joint pain, cough, runny nose, changes in urine output, diarrhoea or other illness, nor contact with infectious diseases, travel history or any routine alterations. They reported that she had received her first influenza virus vaccine [route and dosage not stated], as a seasonal flu vaccine, 8 days before presentation. Upon physical examination, her eruption appeared like a mix of hives and bruises. Her rash was not pruritic or raised and it blanched in response to pressure. The remaining physical examinations were normal. Urinalysis revealed microhaematuria. Based on the examinations and her presentation and absence of thrombocytopenia, she was diagnosed with HSP. Her mother was instructed to bring her to the emergency department in case of development of symptoms including gross haematuriam abdominal pain or arthralgias. She was scheduled for a follow-up visit one week later. At the follow-up visit, she appeared active and cooperative; three days before the visit, her rash had recovered without residual haematomas. Her laboratory examination including complete blood count, creatinine, blood urea nitrogen, complement panel (C3, C4), rheumatic panel, immunoglobulins, coagulation studies and urinalysis were all within normal limits. As she was discharged from the emergency department, a diagnosis of influenza virus vaccine-related HSP was considered. Her mother was advised to performed urine analysis weekly for six weeks. Kantor R, et al. Henoch-schonlein purpura post-influenza vaccination in a pediatric patient: A rare but possible adverse reaction to vaccine. Israel Medical Association Journal: 803517786 Imaj 22: 588-590, No. 10, Oct 2020

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Reactions 28 Nov 2020 No. 1832