A 9-year-old boy with a past medical history of asthma was admitted from the emergency department (ED) for evaluation of a rash, polyarthralgia, and hyperglycemia noted at the referring hospital. The rash was reported as purpuric "bumps," which started 3 days prior to presentation. The rash had initially presented on the lower extremities and had progressively worsened as well as spread to both upper extremities. He also complained of pain in his right knee and lower extremity swelling with limited flexion bilaterally. There was no history of polyphagia, polydipsia, nausea, vomiting, diarrhea, abdominal pain, headache, or fever. The patient mentioned that he had lost approximately 10 lbs during the past year, but he had been trying to lose weight.
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