skip to main content

IgA vasculitis (HSP) — MCCQE Part 1 MCQ

Instant feedback + full explanation. One question, done properly.

HardRashIgA vasculitis (HSP)MCCQE Part 1

An 8-year-old girl develops palpable non-blanching purpura over the buttocks and legs, ankle arthralgia, and colicky abdominal pain after an upper respiratory infection. Platelet count and coagulation studies are normal. Urinalysis shows microscopic hematuria without reduced kidney function. Which diagnosis and follow-up plan are most appropriate?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — IgA vasculitis; arrange serial blood pressure, urinalysis, and kidney assessment

The distribution of palpable purpura, normal platelet count, arthralgia, abdominal pain, and microscopic hematuria is characteristic of IgA vasculitis. Most children recover, but renal involvement determines important long-term risk and can emerge or worsen after the rash and gastrointestinal symptoms resolve. Follow-up therefore includes serial blood pressure, urinalysis for hematuria and proteinuria, and kidney-function assessment over an appropriate period, with nephrology referral for significant or persistent proteinuria, hypertension, reduced kidney function, or nephritic or nephrotic features. Immune thrombocytopenia would generally have thrombocytopenia and does not explain this classic systemic pattern. Meningococcemia is usually an acute toxic illness. Platelet transfusion does not treat IgA-mediated renal disease.

Reference: International Pediatric Nephrology Association, Clinical Practice Recommendations for IgA Vasculitis Nephritis: https://pmc.ncbi.nlm.nih.gov/articles/PMC11666671/