Damage to legs from Henoch-Schonlein purpura? Stumped the doctors

Posted by jsimmons74 @jsimmons74, Apr 18, 2020

My son, 13 at the time, was diagnosed with HSP vasculitis February of 2018. Took several days to diagnose because he did not present with purpura rash on legs. He was in the hospital for 14 days. After 9 days of uncontrolled pain (including nerve blocks, morphine and hydrocodone) he was transferred to Vanderbilt in Nashville and was treated with Toradol, released 3 days later. Then treated with steroids for 4 months. 60 mg for a month, then 40, then 20, then 10. He seemed to recover. We then moved to Chicago in June 2018. July of 2018 he would complain when standing that his legs itched. Went to see Rheumatologist who said if it got worse to a vein dr. Legs only seemed to itch when standing still so my son did not want to see a dr. August 2019 the itching of the lower legs has started to get worse when standing. His legs turn bright red, but subside when he moves or sits down with legs up. By January 2020 his legs have become extremely painful when standing still for just a few minutes. PC doctor tried to get us into a Vein Doctor, but no one would see him because he was "pediatric". He is now 15 and over 6 feet tall. I continued to call around to all kinds of doctors trying to find SOMEONE to see him as his symptoms got worse. Finally got an Interventional radiologist at Lurie Children's Hospital to see him. He was able to watch my son's legs turn bright red between his ankles and knees as he stood still for the ultra sound. He said the ultrasound appeared normal, except for slightly narrow veins, and that he had never seen anything exactly like my son's issues. He referred us to a Vein doctor at Northwestern for more tests speculating the HSP may have done damage to the valves in the veins. The doctor at Northwestern did a more detailed ultrasound of the leg "simulating" standing by using cuffs around his ankles. The test did not produce the pain or reaction that normally happens in his legs while standing. The vein doctor also said he had also not seen anything quite like this, but the valves seem to be working normally. He asked my son if compression socks helped. My son said "no" and the doctor said that further confirmed that it most likely was not a valve issue. We were referred us back to a rheumatologist at Lurie Children's Hospital. His symptoms have steadily gotten worse. Started out as just itching, then a little bit red, then purple legs between ankles and knees. Now it has travelled into his feet and just above his knees and has been more and more painful. His legs turn crazy colors or red and purple and the pain has increased from itching to tingling to very painful now. The pain will subside if he gets up and moves around or sits down with his feet up in a recliner. It used to only happen when he stood still, now it happens while he is stilling down playing Tuba. He also complains of lack of breath when plays now. He sometimes gets really bad leg cramps. We are still waiting for an appointment because Covid19 has now happened we do not know when we will actually get him in. I have several pictures of his legs and didn't know if there was a way to post those. I have read all the different vasculitis and none of them seem to fit. It is getting to a point where it bothers him multiple times daily now. He is getting angry and frustrated as it gets worse. As a mother I worry about long term issues and know how much pain he was in the first time and do NOT every want to see him there again. Any ideas from anyone? He loves marching band and really wants to try out for DCI, but that requires that he be able to stand still and also be extremely active. At this time he can do neither.

Interested in more discussions like this? Go to the Autoimmune Diseases Support Group.

No she was diagnosed in the ER monday. I have a follow up w her pcp on tuesday. Im hoping to get some questions answered then.

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Food restrictions for HSP patient?

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@jsimmons74
@colleenyoung

Dear jSimmons,

I am new to HSP IGA Vasculitis diagnosis, 9/2021.

Mayo connect sent me your thread.

First, I hope you have been able to get some answers and relief for your son. I admire and honor your advocacy for him. Please tell your son he is not alone and he is brave. I hope his lung involvement has been stabilized.

Would you be willing to share an update on your son?

I am new to diagnosis and may not have anything of value to share but one thing that helps me with the painful itching, and burning sensation in my legs and feet is definitely elevation, as your son does, and while elevated packing in ice.

I have body ice bags that are soft, flexible, large and have helped me target cold to area of greatest pain.

My layman theory is, where skin is thin, when inflammation occurs, it is literally pulling our skin and blood vessels are breaking. Cool perhaps works to constrict the blood vessels thus less burning, itching. Pain.

I also have found some relief with oral Benadryl.

I am just beginning to build a medical team. A dermatologist, nephrologist and PCP thus far. Adding pulmonology, gi, rheumatology next.

I will keep reading the responses to your thread.

Thank you for posting here.
June

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@junetooth

@jsimmons74
@colleenyoung

Dear jSimmons,

I am new to HSP IGA Vasculitis diagnosis, 9/2021.

Mayo connect sent me your thread.

First, I hope you have been able to get some answers and relief for your son. I admire and honor your advocacy for him. Please tell your son he is not alone and he is brave. I hope his lung involvement has been stabilized.

Would you be willing to share an update on your son?

I am new to diagnosis and may not have anything of value to share but one thing that helps me with the painful itching, and burning sensation in my legs and feet is definitely elevation, as your son does, and while elevated packing in ice.

I have body ice bags that are soft, flexible, large and have helped me target cold to area of greatest pain.

My layman theory is, where skin is thin, when inflammation occurs, it is literally pulling our skin and blood vessels are breaking. Cool perhaps works to constrict the blood vessels thus less burning, itching. Pain.

I also have found some relief with oral Benadryl.

I am just beginning to build a medical team. A dermatologist, nephrologist and PCP thus far. Adding pulmonology, gi, rheumatology next.

I will keep reading the responses to your thread.

Thank you for posting here.
June

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Body ice

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@lmcazares

My 6 year old daughter was just diagnosed w HSP. Any info or advise
She has high fevers, abd pain ,rash, pain in legs

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@lmcazares
So sorry to hear of your daughters diagnosis.

I am new to HSP. One thing that has helped me is to pack my burning, itching, painful legs and feet in body ice.

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@junetooth

@lmcazares
So sorry to hear of your daughters diagnosis.

I am new to HSP. One thing that has helped me is to pack my burning, itching, painful legs and feet in body ice.

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Thank you the rash has gone down, She still has joint pain and must get her kidneys check 1x a week for a few months.

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@lmcazares

Thank you the rash has gone down, She still has joint pain and must get her kidneys check 1x a week for a few months.

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Don’t be surprised if the rash recurs. Mine cycles about every 21 days.

Watch her kidneys carefully.

I understand kidney damage is more common in adults than children. That’s hopeful for your sweet girl.

I pray this will be a one off for her and will stay at bay.

To good health!

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I'm 60plus having same problem I have pictures went to hospital when my flare was at it's best I was in hospital for 3 days 2CT, MRI, and more then came the famous words we don't know what it is and discharged me. I thought well thank you very much but I could have been at home on the floor with feet on couch loaded with packs of ice 7 years and counting no doctor knows what it is or how it feels the pain is unbearable and if I say that at my age God bless your son my next step is Vascular surgeon oh I hope it's not one of those who have commercial on TV for veins I swear I'll run I have so many things I've been diagnosed with and yet this has no name 😀 I've been thinking circulation bad blood flow to heart. Dear Covid, what will you do next?

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@margaretsousa7205
Margaret,
I’m new to this site.

To share experience, my first question is are we dealing with something similar?

Is your presentation flushing of legs or lesions on legs/buttocks? Photos to upload?

If lesions, have you had a skin biopsy of any of your lesions performed by your local dr. Hospital and sent to Mayo for classification?

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@junetooth

@margaretsousa7205
Margaret,
I’m new to this site.

To share experience, my first question is are we dealing with something similar?

Is your presentation flushing of legs or lesions on legs/buttocks? Photos to upload?

If lesions, have you had a skin biopsy of any of your lesions performed by your local dr. Hospital and sent to Mayo for classification?

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Neither flushing or legions. I may have miswritten, I apologize, my condition is lower Edema and Bruising right leg only. I do have an update..I went to a Vascular surgeon, recommend by my primary care. He suggested compression stocking I let him know that I've been doing that along with elevation and ice packs. I felt like a real idiot bc his next suggestion was again something I've been doing for years no sugar/salt/red meats you know the you are what you eat diet lol you asked 4 photos please sit down first

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