Gabriel Yip and his battle with HSP

 This post was made in 2013, reposting as old website crashed and burnt.
On May 13th 2013, exactly 3.13pm when he got back from school, Gabriel complained that his legs are aching while I can see noticeable swelling on his body. As he walked in, I thought he fell down at school thus the bruises on his legs. So first thing I did was ask him to go for a shower to clean up and reduce the swelling (it was a hot day so initial uninformed assessment was heat rashes). On closer examination after he took his bath that I realized that something is gravely wrong as the rashes and bruises seem to have spread to everywhere on his body in that short 15 minute from the time he got home to after shower, off we went to the Children Clinic just down the road from our home. Initially, I thought it was something he picked up from our neighboring children/school that he plays with but was confirmed by the doc that that's not the case but advised for me to bring him to the hospital immediately.

First, we headed off to Tropicana Medical Center to have a proper check but upon confirmation from the M. O., we were told to admit him into the hospital. I requested for a switch to University Malaya Medical Centre (UMMC) as that's where he was born and they have all his records from his birth to his injection schedules and I also believe that they provide better medical care to the patients compared to the private establishments as they only provide the necessary care and meds as and when it's required. Decisions are not made to suck money out of us based on my experience here.

Initial diagnostics at the Pediatrics Emergency unit confirmed that it's Henoch-Schönlein Purpura or HSP in short.

What is HSP? It's a disease that causes small blood vessels in the body to become inflamed and leak. The primary symptom is a rash that looks like many small raised bruises. HSP can also affect the kidneys, digestive tract, and joints. HSP can occur any time in life. Most people recover from HSP completely, though kidney damage is the most likely long-term complication. In adults, HSP can lead to chronic kidney disease (CKD) and kidney failure, described as end-stage renal disease when treated with blood-filtering treatments called dialysis or a kidney transplant.

Henoch-Schönlein purpura is caused by an abnormal immune system response in which the body’s immune system attacks the body’s own cells and organs. Usually, the immune system makes antibodies, or proteins, to protect the body from foreign substances such as bacteria or viruses. In HSP, these antibodies attack the blood vessels. The factors that cause this immune system response are not known. However, in 30 to 50 percent of cases, people have an upper respiratory tract infection, such as a cold, before getting HSP.

HSP has also been associated with

• infectious agents such as chickenpox, measles, hepatitis, and HIV viruses
• medications
• foods
• insect bites
• exposure to cold weather
• trauma

Genetics may increase the risk of HSP, as it has occurred in different members of the same family, including in twins. So I will have to take note on Grace as well as the chances is low but it might infect her as well. As far as I know, both my ex-wife and myself does not have this issue growing up and checks with our family members reveals that none of them have HSP before.

At present, the doctors told us that Gabriel has to be in the hospital for at least 5 days (so hopefully we can be out of here by Friday) but then, if things turn for the worst, then there are chances that we'll be in here longer. Aside from the hour checks on his BP and blood tests, only medication they are providing us are pain killers to ease the pains he is experiencing at his joints. Aside from that, no major serious stuff is on. No drips, no surgeries. Which is a good thing.

Some of the symptoms of HSP that he is experiencing include the following:

Rash : Leaking blood vessels in the skin cause a rash that looks like bruises or small red dots on the legs, arms, and buttocks. The rash may first look like hives and then change to look like bruises, and it may spread to the chest, back, and face. The rash does not disappear or turn pale when pressed.

Arthritis: Pain and swelling can occur in the joints, usually in the knees and ankles and less frequently in the elbows and wrists.

Kidney involvement - Hematuria: Blood in the urine—is a common sign that HSP has affected the kidneys. Proteinuria: Large amounts of protein in the urine—or development of high blood pressure suggests more severe kidney problems.

Aside from that, lucky that he's not experiencing these as well..

Digestive tract problems: HSP can cause vomiting and abdominal pain, which can range from mild to severe. Blood may also appear in the stool, though severe bleeding is rare.

• Other symptoms: In some cases, boys with HSP develop swelling of the testicles. Symptoms affecting the central nervous system, such as seizures, and lungs, such as pneumonia, have been seen in rare cases.

Though the rash affects all people with HSP, pain in the joints or abdomen precedes the rash in about one-third of cases by as many as 14 days.

From what I gather at, there is no specific treatments for HSP. The main goal of treatment is to relieve symptoms such as joint pain, abdominal pain, and swelling. People with kidney involvement may receive treatment aimed at preventing long-term kidney disease. I've also applied calamine lotion on his rash area to cool the area down and keep him from scratching out of irritation. Until his rashes subsides and the doctor give the all clear, there's not much that can be done also.

For me, only thing I can do is just sit here and watch over him until he is out of this ordeal. Until then, had to cancel a lot of the appointments and projects that I'm involved in. Making money is vital but it's never really my priority, especially at this moment. My children is. Lastly, thank you friends for all the kind words and prayers. Will let Gabriel know that a lot of great uncle and aunties (yes, regardless of your age, you are in that category known as Uncle and Aunties) want him to recover faster.

In the end, we spend 2 months in the hospital (we were later moved to Kuala Lumpur General Hospital for 2 weeks)  and the year after that going in and out of KLGH for observations and doing blood test to make sure that everything is in check. That does not mean that I'm not worried even up to this day.

Michael Yip

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