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Should children with Henoch-Schonlein purpura and abdominal pain be treated with steroids?
  1. M Haroon
  1. Dept of Paediatrics, York District Hospital, UK; munibharoon@hotmail.com

https://doi.org/10.1136/adc.2005.077743

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    Hannah is a 7 year old girl with Henoch-Schonlein purpura (HSP). She has a lot of abdominal pain which is not settling with simple analgesia. An ultrasound scan reveals that she does not have an intussusception. The SHO on-call tells you that her handbook of paediatrics says that such pain can be treated with steroids, but is there really any evidence to support this?

    Structured clinical question

    Do children with abdominal pain and HSP [population] treated with steroids [intervention] compared to children treated without steroids[comparison] show a more rapid resolution to their symptoms [outcome]?

    Search strategy and outcome

    Secondary sources

    Best Bets: “Henoch Schonlein purpura”; match all/any words. No relevant citations.

    “Steroids abdominal pain”; match all words. No relevant citations.

    Match any words; 125 hits, no relevant citations.

    Cochrane: “henoch schonlein purpura” (MeSH); 11 hits. None relevant.

    “steroids” and “abdominal pain”; 43 hits. None relevant.

    Primary source

    Medline 1966–2004:

    “Henoch Schonlein Purpura” AND “steroids” AND abdominal pain; 21 citations; 2 relevant.

    “Henoch …

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    Footnotes

    • This case is based on experience from several cases. Details have been altered to ensure patient anonymity

    • Edited by Bob Phillips