“My kid woke up in excruciating pain with rashes on her legs”

Mum Angela Thomas recounts her 7-year-old daughter’s brush with a potentially life-threatening ― and uncommon ― autoimmune disorder.

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“A few weeks ago, my daughter, Kristal, called my husband in the middle of a school day complaining of a tummy ache. I remember that she’d mentioned that she was feeling unwell that morning, but since it didn’t seem too serious, we sent her to school.

When my husband picked her up, Kristal also told him that she had also vomited earlier after taking a bite of her sandwich. We immediately took our distraught daughter to our family GP.

As he was examining her, our doctor noticed that Kristal had flat, red dots around her shin area. I had noticed it, too, the night before, but hadn’t thought too much about it. When he asked about her medical history, we told him that Kristal had just had an upper respiratory infection ― a minor cold and sore throat. She had been ill only for a few days, and we self-medicated, after which she recovered fully.

The rash on her right leg ― small, red pin-pricks that don’t disappear when you press on the skin ― made our doctor suspect that she was suffering from a disease called Henoch-Schonlein Purpura (HSP). But since it was very uncommon, especially amongst Asians, he decided to treat the tummy ache with some meds first. We were told to keep a close eye on how the condition progressed.

Kristal didn’t sleep much that night as she continued to complain about her tummy pain. But we ruled out appendicitis, since the pain was opposite the appendix.

The next day, we noticed that more rashes had popped up on Kristal’s other leg. We began to suspect that it could be HSP. So, we got a referral to a paediatrician who is also an immunology specialist.

As the earliest appointment was two days away, we managed the pain with the meds we had. However, my husband and I started to worry more when Kristal began to limp the next day. She complained that the balls and heels of her feet were aching. When I took a look, I saw more rashes there.

“My husband and I started to worry more when Kristal began to limp the next day. She complained that the balls of her feet was aching. When I took a look, I saw more rashes there.”

Since we couldn’t see the specialist sooner, I decided to learn more about HSP from “Dr Google”. Exactly what was this disease? I had never heard of it before in my life. Neither had my husband or any of our family and friends. Searches threw up symptoms that Kristal seemed to have, especially the rashes and abdominal pain.

There was no definitive cause, but according to what I read, HSP usually follows an upper respiratory tract infection, which had probably raised the red flags for Kristal’s doctor.

HSP can apparently attack anyone, but most often, boys between the ages of 2 and 11 are at the highest risk. It also seems more common in the Western world, which explained why none of us had ever heard about it. My husband is half Welsh, which may explain why Kristal got it.

The stories I read online freaked me out. HSP can be a lifelong, debilitating battle and it can also affect the kidneys. Yikes! I decided to stop doing research on the condition and wait patiently to see the doctor in two days to get proper information.

The next day was Monday, but Kristal stayed home to recuperate. On Tuesday, the day we were going to see the specialist, Kristal announced that she was feeling better ― although she had a slight tummy ache, she wanted to go to school. We gave her some Ibuprofen and sent her to school feeling hopeful that it might not be HSP after all.

However, at around 11.30am, Kristal called her father. She was feeling very lethargic and couldn’t keep her eyes open in class. We picked up our daughter and headed straight to the paediatrician at Gleneagles Hospital, which our GP referred Kristal to.

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Dr Liew Woei Kang of SBCC Baby & Child Clinic took one look at Kristal and confirmed our greatest fear ― it was HSP. He was concerned that the disease could have affected Kristal’s kidneys, so he did a urine and blood test immediately. The results were reassuring.

However, we noticed that the rashes had grown slightly bigger and were blue-black instead of red. It had also spread from her shin to the back of her forearms and right ear. Dr Liew explained that the rashes were caused by blood leaking out of the vessels, but assured us that since the spots were darker, this meant that the body was healing.

The next morning, my daughter threw up bile. She was unable to keep anything down, apart from pancakes. Complaining that her tummy ached, she rated her pain seven on a scale of 10. Desperately worried for our daughter’s well-being, my husband and I took her back to see Dr Liew the following day.

Dr Liew was concerned that the vomiting could be a sign of intussusception ― when one end of the intestines slides into the other end, much like the pieces of a telescope. Linked to HSP, it can cause inflammation and infection, since the bowels can be obstructed.

An ultrasound was done to check for intussusception. I still remember the tension in the room and the concerned look the ultrasound technician had on her face. She didn’t want to tell us much until she brought another doctor into the room for a second opinion.

I started freaking out and was conjuring up worst-case scenarios in my head, especially when that doctor asked for an MRI specialist’s opinion to confirm his diagnosis. But I knew I had to be strong as my little girl was looking even more confused and worried over what was going on. After much deliberation, the doctors concurred that the bowel was probably inflamed, so it was not intussusception. What a relief!

“I’m so proud of my daughter, who has been such a trouper throughout this painful journey.”

The HSP didn’t seem to be creating much havoc in Kristal’s body, so Dr Liew prescribed prednisolone tablets ― this steroid helps to reduce inflammation and pain. I gave Kristal six tablets for the first dose and she finally slept like a baby throughout the night. She also woke up in much better spirits.

Kristal continued taking this same dose for the next three days and nights on a 12-hourly schedule. My little girl has been responding well to the medication so far. I’m not too thrilled about her being on such strong meds for too long, so now, we have decreased it to two tablets. She will have to see Dr Liew for follow-up checkups.

Unfortunately, the HSP meds tend to lower a person’s immunity ― our little girl caught a really bad bout of flu a week after she was diagnosed. Though she was ill for several days, she’s on the mend now. Her tummy aches come and go sporadically, although they aren’t as painful as they initially were.

I’m so proud of my daughter, who has been such a trouper throughout her painful journey. Not once has she complained about having to take those tablets. And although she hated getting her blood drawn and was so afraid when she was at the doctors, Kristal knew it had to be done and sucked it up. What a brave girl I have!

This entire ordeal had also made me realise how important a good GP is. Without our GP’s quick catch, Kristal would have had to endure more days of excruciating abdominal pain, while we tried to figure out what was wrong. I’m so glad it was caught and treated early, so that my daughter didn’t have to suffer too much.”

Angela Thomas, 43, is mum to Kristal, 7.

Photo: iStock

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