New-Onset Henoch–Schonlein Purpura after COVID-19 Infection: A Case Report and Review of the Literature

Abstract

Extrapulmonary manifestations of COVID-19 infection include a wide spectrum of cutaneous, endocrine, and cardiovascular complications. We report three cases of new-onset Henoch–Schonlein purpura (HSP) in COVID-19 infected children that were diagnosed and treated in Abha Maternity and Children Hospital, Saudi Arabia, between 28th July 2020 and 10th August 2020. All three cases were males younger than 5 years of age that presented with Henoch–Schonlein purpura characteristic rash and arthralgia without a recent history of any infection, especially respiratory infections. They all tested positive for COVID-19. At the time of the admission, pediatric COVID-19 cases were managed conservatively and we ruled out any other diagnosis before establishing the diagnosis of Henoch–Schonlein purpura according to the clinical picture. The three boys responded significantly to prednisolone and achieved a rapid recovery. We present the clinical scenario and laboratory tests of these children along with pictures of the lesions detected in each case.

Viral Infections May Be Associated with Henoch–Schönlein Purpura

“…SARS-CoV-2 may directly infect endothelial cells or cause an inflammatory response as a result of the infection. Angiotensin-converting enzyme 2 (ACE2) receptors, scavenger receptor B type 1 (SR-B1), and other cell wall receptors facilitating the entry of the virus to the endothelial cells are some of the hypothesized factors involved in viral cell invasion [ 36 ].…”

Adult-Onset IgA Vasculitis Associated With Pulmonary-Renal Syndrome Following COVID-19 Infection: A Case Report and Literature Review

“…Also, the study showed that critical and non-survivor groups tend to have an increase in creatine kinase (CK), C-reactive protein (CRP), procalcitonin, lactate dehydrogenase (LDH), urea, creatinine, D-dimer, prothrombin time (PT), erythrocyte sedimentation rate (ESR), interleukin-6 (IL-6), neutrophils, and total white blood cells (WBCs) and a decrease in arterial oxygen partial pressure/fractional inspired oxygen (pO2/FiO2), pO2, lymphocyte, and platelet (PLT) values when compared to other groups [7]. COVID-19-induced IgA vasculitis has been described in prior case reports [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26]. However, these case reports were mainly in pediatrics or the very old age group [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26].…”

“…COVID-19-induced IgA vasculitis has been described in prior case reports [ 8 - 26 ]. However, these case reports were mainly in pediatrics or the very old age group [ 8 - 26 ].…”

“…COVID-19-induced IgA vasculitis has been described in prior case reports [ 8 - 26 ]. However, these case reports were mainly in pediatrics or the very old age group [ 8 - 26 ]. In this report, we describe a case of a healthy adult Saudi female patient who was diagnosed with IgA vasculitis manifesting with pulmonary-renal syndrome following a recent infection with COVID-19.…”

Coagulopathy and thromboembolism in children with COVID-19 – pathophysiology, thrombotic risk, clinical manifestations and management

“…PIMS more frequently affects boys than girls, with a median age of 8 years [10]. The main target of SARS-CoV-2 is the respiratory system, while extrapulmonary manifestations include a broad spectrum of cutaneous (IgA-associated vasculitis), neurological, endocrine, cardiovascular (myocarditis) and acute renal failure complications [5,11,12]. Cardiogenic shock, electrocardiographic (ECG) changes, left ventricular dysfunction, and coronary artery dilatation have been reported among patients with PIMS-TS [12].…”