Psychiatry and Clinical Psychopharmacology

Henoch-Schönlein Purpura with attention deficit hyperactivity disorder

Psychiatry and Clinical Psychopharmacology 2014; 24: Supplement S158-S159
Read: 1973 Published: 18 February 2021

Henoch-Schönlein purpura (HSP) is one of the most common vasculitis of childhood and frequently associated with the gastrointestinal tract involvement, manifesting as abdominal pain, vomiting and GI bleeding. The etiology is unclear. Interaction of several environmental factors, including infections and multiple genes has been proposed to play a role in pathogenesis. Neurological symptoms are rare although non-specific headache followed by subtle encephalopathy with minimal changes in mental status, such as labile mood, apathy and hyperactivity may be more common than previously thought. In a prospective study 46% of 26 patients had abnormal EEGs. It represents a diffuse vasculitis that is secondary to hypersensitivity. Neuropsychiatric conditions can also be seen in the latter, including attention deficit hyperactivity disorder (ADHD), being more frequent in the chronic forms of the disease. We report a case of a 11-year-old male HSP patient with ADHD. He is a 6th grader. When he was in primary school, he learned reading at 1st class. He had a high academic achievement but he has been getting bored quickly of lessons since the 1st class and he has got attention problems. The case had no resume medical histories. ECG is within the normal values. From when our case was 2-3 years of age, was referred Behcet Uz Hospital in September 2001 with the purpuric rashes, swollen legs. He had taken antibiotic. The case had no history of infection or animal/insect bites at least until the onset of rashes. The case was diagnosed as having HSP. ADHD is one of the most common childhood brain disorders and can continue through adolescence and adulthood. Symptoms include difficulty staying focused and paying attention, difficulty controlling behavior, and hyperactivity (over-activity). These symptoms can make it difficult for a child with ADHD to succeed in school, get along with other children or adults, or finish tasks at home. ADHD is a common disorder of complex pathology with several possible treatment options. The first-line treatment of ADHD is the prescription of stimulant drugs such as methylphenidate. In this case we point out that methylphenidate with behavioral management was associated with benefit in the management of ADHD with HSP and additional cognitive impairments. Methylphenidate appears to be a safe and effective treatment for ADHD in the majority of children with HSP. In our case a 12-year-old child with a diagnosis of ADHD had an academic success; methylphenidate treatment was carried out and our patient has got benefits. If Children diagnosed with ADHD have a history of vasculitis, the treatment of methylphenidate may be the first option. During the early years of children, as the neurodevelopment is in progress, HSP should be followed up in advanced stages for ADHD, if diagnosed.

EISSN 2475-0581