Accurate diagnosis of acute hemorrhagic edema of infancy: a French multicenter observational study - Archive ouverte HAL Accéder directement au contenu
Article Dans Une Revue European Journal of Pediatrics Année : 2023

Accurate diagnosis of acute hemorrhagic edema of infancy: a French multicenter observational study

Marie-France Chinazzo
  • Fonction : Auteur
Emmanuel Mahé
  • Fonction : Auteur
Patrice Plantin
  • Fonction : Auteur
Juliette Mazereeuw-Hautier
  • Fonction : Auteur

Résumé

The purpose of the study is to highlight clinical signs that are either suggestive of or against the diagnosis of AHEI to improve diagnosis and management. The medical records of children under 3 years old diagnosed with AHEI were retrospectively reviewed. Clinical data and photographs were reviewed by three independent experts, and the cases were classified as probable, doubtful, or unclear AHEI. Of the 69 cases of children diagnosed with AHEI included in 22 centers, 40 were classified as probable, 22 as doubtful, and 7 as unclear. The median age of patients with probable AHEI was 11 months [IQR 9–15], and they were in overall good condition (n = 33/40, 82.5%). The morphology of the purpura was targetoid in 75% of cases (n = 30/40) and ecchymotic in 70% of cases (n = 28/40) and affected mostly the legs (n = 39/40, 97%), the arms (n = 34/40, 85%), and the face (n = 33/40, 82.5%). Edema was observed in 95% of cases and affected mostly the hands (n = 36/38, 95%) and feet (n = 28/38, 74%). Pruritus was absent in all patients with probable AHEI and described for 6/21 with doubtful AHEI (29%). AHEI was the original diagnosis in only 24 patients (n = 24/40, 60%). The major differential diagnoses were purpura fulminans and urticaria multiforme. Conclusion: AHEI, which the diagnosis is made on clinical findings, is often misdiagnosed. Purpuric lesions localized on the face/ears, arms/forearms, and thighs/legs with edema of the hands without pruritus in a young child with a good overall condition are highly suggestive of AHEI.
Fichier principal
Vignette du fichier
Manuscript R1.pdf (267.13 Ko) Télécharger le fichier
Figure 1.tif (10.23 Mo) Télécharger le fichier
Figure 2.tif (1.8 Mo) Télécharger le fichier
Figure 3.tiff (27.66 Mo) Télécharger le fichier
Supplemental file R1.pdf (27.15 Ko) Télécharger le fichier
Origine : Fichiers produits par l'(les) auteur(s)

Dates et versions

hal-04214157 , version 1 (22-09-2023)

Identifiants

Citer

Sophie Leducq, Annabel Maruani, Christine Bodemer, Sandra Biscardi, Olivia Boccara, et al.. Accurate diagnosis of acute hemorrhagic edema of infancy: a French multicenter observational study. European Journal of Pediatrics, 2023, 182, pp.4133-4141. ⟨10.1007/s00431-023-05098-7⟩. ⟨hal-04214157⟩
42 Consultations
13 Téléchargements

Altmetric

Partager

Gmail Facebook X LinkedIn More