1. Image Challenge
Q: What is the diagnosis in this patient who had abdominal pain?
1. Familial Mediterranean fever
2. Henoch-Schönlein purpura
3. Meningococcemia
4. Polyarteritis nodosa
5. Rocky Mountain spotted fever

2. Image Challenge
Q: What is the diagnosis in this patient who had abdominal pain?
Answer:
2. Henoch-Schönlein purpura
Skin biopsies revealed leukocytoclastic vasculitis with IgA deposition, which is consistent with
IgA vasculitis (Henoch-Schönlein purpura). The patient was treated with high-dose
glucocorticoids including pulse therapy, which were tapered successfully after cyclosporine
was added to the treatment. Henoch-Schönlein purpura, a systemic small-vessel vasculitis,
causes palpable purpura in the lower extremities, abdominal pain, arthralgia, and
glomerulonephritis.