2 Year Old Boy with Brain Hemorrhage

A two year old boy of a friend collapsed two weeks ago.  He stopped breathing and had no pulse.  After successfully being revived he was rushed to a nearby children's hospital where they determined he had suffered an unexplained hemorrhage on the right side of his brain.  The boy had been suffering from Purpura rash below his knees for two weeks prior to the hemorrhage that was mistaken for ant bits. He had a history of frequent ear infections and had additional symptoms at the time of the collapse of dual eye and ear infections and reduced sensations (he accidently burned his hand in the kitchen without feeling it).  The boy also maintained a fever above 100 degrees for over two weeks originally above 102 degrees for 3-5 days at onset.  His multiple trips to his pediatrician were unsuccessful in diagnosing any correlation between the symptoms. After resuscitation, the child was posturing with his limbs and gritting his teeth.  He remains in critical condition but is breathing on his own in ICU.  The Purpura rash has recurred, again only from the knees to his feet.  Are these symptoms possibly linked? Could this be some type of vasculitis?  What should the parents ask of the medical staff at his hospital to confirm these suspicions?

[Bhupinder Kaur, MD]

Hello,

Two possibilities are there.Firstly,it can be a vasculitis.Secondly,it can be a bleeding disorder.

Vasculitis is inflammation and/or damage to the blood vessels, ranging from moderate to severe.In children,two types of vasculitis are found:
1)Kawasaki disease: an acute self-limited immune-mediated form of vasculitis that primarily affects infants and young children.Diagnosed by perinuclear anti-neutrophilic cytoplasmic antibodies (P-ANCA), increased white blood cell count, anemia, elevated erythrocyte sedimentation rate (sed rate), elevated C-reactive protein (CRP) level, and an increased platelet count.
http://autoimmunedisease.suite101.com/article.cfm/kawasakis_disease
2) Henoch-Schönlein purpura: a systemic vasculitis (inflammation of blood vessels) characterized by deposition of immune complexes containing the antibody IgA in the skin and kidney.Diagnosed by skin biopsy,serum creatinine and uric acid, raised IgA levels, raised C-reactive protein (CRP) and raised platelet count.

Second possibility is of bleeding disorder like hemophilia(Hemophilia is an inherited bleeding disorder. The blood of someone with hemophilia will not clot normally. Bleeding may occur spontaneously or following injury)

Pls discuss these possibilities with the doctor.

Take care and pls do keep us posted on how your friend’s son is doing.