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Henoch-Schönlein Purpura in Primary Care: The Importance of a Holistic Assessment
Púrpura de Henoch-Schönlein nos Cuidados de Saúde Primários: A Importância de uma Avaliação Holística
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Ana Rita Queirós [queiros.rita.ana@gmail.com]
Medicina Geral e Familiar, Unidade Local de Saúde Santo António, Unidade de Saúde Familiar Garcia de Orta, Porto, Portugal
Rua Pinho Leal 29, 4150-620 Porto
Abstract
Henoch-Schönlein purpura (HSP) is a rare vasculitis in adults, requiring a high index of suspicion. This case highlights the role of Primary Healthcare and a comprehensive assessment in early recognition.
A healthy 27-year-old female presented to the Emergency Department (ED) with abdominal pain and vomiting and was discharged with suspected gastroenteritis. Four days later, she consulted her Family Doctor for persistent symptoms. A thorough review revealed arthralgia, rectal bleeding and palpable purpura on both lower limbs. She was promptly referred back to the ED. Laboratory results and abdominal ultrasound had no major alterations and abdominal computed tomography (CT) suggested inflammatory enteritis.
She was admitted for a diagnostic skin biopsy and initiated on corticosteroid therapy for suspected HSP. The patient showed a favorable clinical response to prednisolone, with stable renal function and blood pressure throughout hospitalization.
This case reinforces the value of Primary Health Care in ensuring comprehensive evaluation and facilitating early diagnosis to prevent complications.
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