Affiliation:
1. Residency School of Pediatrics, Department of Health Sciences University of Florence Firenze Italy
2. Rheumatology Unit, ERN ReCONNET Center Meyer Children's Hospital IRCCS Florence Italy
3. NEUROFARBA Department University of Florence Firenze Italy
4. Pediatric Unit Meyer Children's Hospital IRCCS Florence Italy
5. Department of Health Sciences University of Florence Florence Italy
Abstract
AbstractPurposeData on acute hemorrhagic edema of infancy (AHEI) are derived from small case series or case reports. We report a 20‐year experience at a national referral center.MethodsWe performed a single‐center retrospective study including patients who were diagnosed with AHEI from January 1, 2004, to June 30, 2023.ResultsWe identified 21 patients (57.1% females) with a median age of 18 months (range 7–33 months). Thirteen (61.9%) patients were admitted to the pediatric ward, the remaining eight (38.1%) presented to the emergency department and were discharged for outpatient management. The median length of hospitalization was 5 days (range 3–9 days). Twenty patients (95.2%) had prodromal symptoms. The most common cutaneous findings were targetoid purpuric plaques. The lesions were most localized on the face (13, 61.9%) and on the upper limbs (18 patients, 85.7%). Sixteen (76%) patients presented with nonpitting and tender edema, localized on the feet (9/16, 56%) and hands (6/16, 37.5%). Systemic involvement was rare, and no patients experienced complications or sequelae. Twelve (57.1%) patients underwent infectious disease investigations, with positive results in only four (33.3%). None of the patients diagnosed after the SARS‐CoV‐2 outbreak (March 2020) had positive nasopharyngeal swabs for the virus. For the 13 patients who were admitted to the pediatric ward, the median length of hospitalization was five days (3–9 days).ConclusionsThe 21‐patient single‐center cohort of children affected by AHEI confirmed a generally benign course of AHEI, despite a 62% rate of hospitalization.