A CASE OF RECURRENT CHLAMYDIA PNEUMONIAE INDUCED HENOCH-SCHÖNLEIN PURPURA IN 8-YEAR-OLD BOY

Henoch-Schönlein purpura (HSP), synonymous with the recent term immunoglobulin A vasculitis (IgAV), is an acute autoimmune IgA-mediated disorder classified under the group of small-vessel vasculitis (SVV). It clinically manifests with the pathognomonic tetrad of palpable purpura, abdominal pain, hematuria or proteinuria, and arthritis. Although the full spectrum of clinical features is not invariably present and additional clinical manifestations may be seen, cutaneous manifestations are observed in 100% of cases, thereby serving as the one most definitive diagnostic criterion. Young children, predominantly between ages of 2 and 10, are generally affected by the disease (90% of the cases), thereby establishing it as the most common vasculitis of childhood. We describe a case of two episodes of Chlamydia pneumoniae induced HSP in an 8-year-old boy with an acute onset of a rash and an upper respiratory tract infection preceding the onset, and with possible simultaneous multi-factorial infective etiology contributing to the severity of the disease. Given the rarity of reported cases, only two to our knowledge, it is challenging to establish a definitive causal relationship between Chlamydia pneumoniae and HSP. However, this uncommon association highlights the importance of considering this atypical pathogen in the etiological differential diagnosis of HSP, especially in patients presenting with preceding respiratory symptoms. Early diagnosis is crucial for preventing complications and ensuring optimal management, with prompt recognition of diverse triggers, such as infections, being essential for tailored therapy and improved patient outcomes.