Acute hemorrhagic edema of infancy: the experience of a large tertiary pediatric center in Israel

Limor Parker, Keren Shahar-Nissan, Liat Ashkenazi-Hoffnung, Liora Harel, Jacob Amir, Omer Trivizki, Efraim Bilavsky

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Acute hemorrhagic edema of infancy (AHEI) is a rare leukocytoclastic vasculitis of the small vessels occurring at a young age and considered as a benign self-limited disease. Due to its low prevalence, there are limited data on the presentation and complications of this disease. Methods: All computerized files of children who were hospitalized at a tertiary pediatric center due to AHEI over a 10 year period were reviewed. Clinical, laboratory and histopathological data were collected. Results: Twenty-six patients were included in our study, accounting for 0.7 cases per 1000 admissions of children aged 2 years or less. Mean age was 12.9 months. More than two thirds of the children had preceding symptoms compatible with a viral infection. Upon admission, all patients presented with typical findings of a rash and edema. Edema was most profound over the lower extremities (73%). Concomitant viral or bacterial infections were found in six children. Skin biopsy was performed in six patients revealing leukocytoclastic vasculitis. Thirteen children (50%) had systemic involvement including joint involvement (n=9), gastrointestinal hemorrhage (n=4), microscopic hematuria (n=1) and compartment syndrome of the limb (n=1). The latter was diagnosed in a patient with familial Mediterranean fever. Conclusions: Our largest data series highlighted what is known regarding clinical and histological findings in children with AHEI. However, contrary to what was previously reported, we found a higher rate of systemic involvement. Although AHEI is a rare entity, pediatricians should be familiar with its presentation, management and our reported complications.

Original languageEnglish
Pages (from-to)341-345
Number of pages5
JournalWorld Journal of Pediatrics
Volume13
Issue number4
DOIs
StatePublished - 1 Aug 2017

Keywords

  • Finkelstein-Seidlmayer disease
  • Henoch-Schönlein purpura
  • acute hemorrhagic edema
  • vasculitis

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