Pediatric Nephrology

, Volume 22, Issue 11, pp 1979–1981 | Cite as

Renal involvement and hypocomplementemia in a patient with acute hemorrhagic edema of infancy

  • Toru WatanabeEmail author
  • Yosuke Sato
Brief Report


Acute hemorrhagic edema of infancy (AHEI) is a cutaneous leukocytoclastic vasculitis that affects children under 2 years of age and is clinically characterized by fever, extensive tender edema and large purpuric lesions that involve mainly the face, ears and limbs. AHEI typically exhibits an acute onset, with a short benign course followed by spontaneous and complete recovery. Visceral involvement is usually absent, and laboratory studies reveal no specific abnormalities. The pathogenic mechanisms underlying the development of AHEI remain unknown. We describe a patient with AHEI exhibiting transient renal involvement and hypocomplementemia. A 19-month-old Japanese boy was admitted to our hospital with a 2-day history of fever and purpura affecting his face, right ear and legs, and a 1-day history of painful edema of the right side of his face and his right lower leg. Laboratory studies revealed microscopic hematuria, proteinuria and hypocomplementemia affecting C4, C1q and CH50. A clinical diagnosis of AHEI was made, and the patient made a rapid and completely recovery without any specific therapy. We suggest that activation of the classical pathway of complement might be one of the pathogenic mechanisms underlying the development of AHEI.


Vasculitis Leukocytoclastic vasculitis Henoch–Schönlein purpura Kidney disease 


  1. 1.
    Snow IM (1913) Purpura, urticaria and angioneurotic edema of the hands and feet in a nursing baby. JAMA 61:18–19Google Scholar
  2. 2.
    Ince E, Mumcu Y, Suskan E, Yalcinkaya F, Tümer N, Cin S (1995) Infantile acute hemorrhagic edema: a variant of leukocytoclastic vasculitis. Pediatr Dermatol 12:224–227PubMedGoogle Scholar
  3. 3.
    Dubin BA, Bronson DM, Eng AM (1990) Acute hemorrhagic edema of childhood: an unusual variant of leukocytoclastic vasculitis. J Am Acad Dermatol 23:347–350PubMedGoogle Scholar
  4. 4.
    Saraclar Y, Tinaztepe K, Andalioglu G, Tuncer A (1990) Acute hemorrhagic edema of infancy (AHEI)—a variant of Henoch–Schönlein purpura or a distinct clinical entity? J Allergy Clin Immunol 86:473–483PubMedCrossRefGoogle Scholar
  5. 5.
    Lantner RR, Ros SP (1996) Acute hemorrhagic edema of infancy. Pediatr Emerg Care 12:111–112PubMedCrossRefGoogle Scholar
  6. 6.
    Amitai Y, Gillis D, Wasserman D, Kochman RH (1993) Henoch–Schönlein purpura in infants. Pediatrics 92:865–867PubMedGoogle Scholar
  7. 7.
    Shetty AK, Desselle BC, Ey JL, Correa H, Galen WK, Gedalia A (2000) Infantile Henoch–Schönlein purpura. Arch Fam Med 9:553–556PubMedCrossRefGoogle Scholar
  8. 8.
    Goraya JS, Kaur S (2002) Acute infantile hemorrhagic edema and Henoch–Schönlein purpura: is IgA the missing link? J Am Acad Dermatol 47:801PubMedCrossRefGoogle Scholar
  9. 9.
    Legrain V, Lejean S, Taïeb A, Guillard JM, Battin J, Maleville J (1991) Infantile acute hemorrhagic edema of the skin: study of ten cases. J Am Acad Dermatol 24:17–22PubMedCrossRefGoogle Scholar
  10. 10.
    Caksen H, Odabaş D, Kösen M, Arslan S, Öner AF, Ataş B, Akçay G, Ceylan N (2002) Report of eight infants with acute infantile hemorrhagic edema and review of the literature. J Dermatol 29:290–295PubMedGoogle Scholar
  11. 11.
    McDougall CM, Ismail SK, Ormerod A (2005) Acute haemorrhagic oedema of infancy. Arch Dis Child 90:316PubMedCrossRefGoogle Scholar
  12. 12.
    Millard T, Harris A, MacDonald D (1999) Acute infantile hemorrhagic oedema. J Am Acad Dermatol 41:837–839PubMedCrossRefGoogle Scholar
  13. 13.
    Smitt JHS, Vermeer MH, Faber WR (2002) Acute hemorrhagic edema of infancy. Clin Dermatol 20:2–3PubMedCrossRefGoogle Scholar
  14. 14.
    Sulyok E (2004) Acute proliferative glomerulonephritis. In: Avner ED, Harmon WE, Niaudet P (eds) Pediatric nephrology, 5th edn. Lippincott Williams and Wilkins, Philadelphia, pp 601–613Google Scholar
  15. 15.
    Offidani A, Cellini A, Bossi G (2001) Acute hemorrhagic oedema of the skin in infancy. Eur J Dermatol 11:63–64PubMedGoogle Scholar
  16. 16.
    Barnhill RJ, Busam KJ, Nousari CH, Xu X, Barksdale SK (2005) Vascular disease, In: Lever’s histopathology of the skin, 9th edn. Lippincott Williams and Wilkins, Philadelphia, pp 215–242Google Scholar

Copyright information

© IPNA 2007

Authors and Affiliations

  1. 1.Department of PediatricsNiigata City General HospitalNiigataJapan

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