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.

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How painful!

Have others seen this presentation?

My presentation is different, so I am not going to be a resource.

Hang in there! Keep searching for answers.

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Thank you I did show the Dr 2day his next suggestion was a cardiologist a little too oil late my mini heart attack was about 5 years ago I've been on 81mg Aspirin 1per day since I'm wondering at this point maybe I can use some non-medical help 😆

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I'm open to any suggestions anyone can give the picture you see is only half of what's going on down there

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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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Please read my post Re: Mayo trial for kidney involvement from IGA Vasculitis.

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@jsimmons74

Thank you for the information. All of his tests so far have been related to the valves in the veins, but now that they have ruled that out maybe the will move on to other testing once we get to see the Rheumatologist. He handles it pretty well most of the time because the pain subsides when he lays down. It doesn’t hurt when he moves so that is a blessing. He is able to walk the dog for some exercise and mow the yard. When it does flair up he gets so angry and frustrated. Now that it bothers him when he is practicing tuba he gets very angry bc it is the one thing he loves doing. Holding out they do not cancel our appt at the end of the month, but I am going to call today and make sure bc it has definitely gotten worse.

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I feel so bad for your son what he has to endure everyday. As his Mom I’m sure it’s not easy on you. It must be taking a toll on you and family. Stay strong💪🏼 Isn’t there other doctors you can get in touch with outside of your area? Prayers a cure is found for your son. Stay strong, keep the faith. prayers for you and your son 🫶🙏

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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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How are the kidneys doing?
Any protein or blood in the urine?
Hopefully not.
I am on a trial with Mayo Of Mycophenolate mofatil . Questions? Reach out.

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Hi jsimmons74,

I am a 31 year old woman who was diagnosed with IGA Vasculitis around 2021. Unsure if it was Covid19 itself or the vaccine, I have it as an adult. I did use prednisone at first and it went into remission for 3 months before it relapsed non-stop since the beginning of 2022.

I have been taking colchicine for twice a day and must wear compression socks to work. I've noticed if I'm on my feet, or be active for long periods of time, my legs will inflame like crazy. They heal in about 2-5 days if I rest. I've had to request a medical accomodation at work. I pretty much have to watch what I eat now because working out likely will trigger inflammation.

My doctors definitely have to monitor me in case for organ damage every 3 months, through blood tests. I've been told by my Rheumatologist that this is as good as it's going to get. If it's severe inflammation prolonging 3 weeks with no reaction to steroids, then they have to move me to a different medication. I'm basically under maintance. I've had to accept this affliction now as a new way of life now. Very hard pill to swallow. My own dad has to do dialysis and suffers from his own kidney failure and it scares me that I might end up like him.

I hope your son is doing well and I hope he knows he's not alone it's many many people out there who are newly being diagnosed with an influx of this autoimmune disease. I hope in his case it will just go away as he gets older. I wish you two the best.

-Ann

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