IgA vasculitis (Henoch-Schonlein purpura)

Oral, usual initial dose 5 to 60 mg per day, as a single morning dose or in 2 to 4 divided doses, then tapered rather than stopped - A short course over the painful phase, tapered - the formulary prints a worked 6-day taper from 30 mg down to 5 mg

0.1-2 mg/kg/day

(The formulary's general anti-inflammatory or immunosuppressive band for infants, children and adolescents: oral, initial 0.1 to 2 mg/kg/day, in divided doses 1 to 4 times daily. No ceiling appears above because the formulary states none for this band; it asks instead for the lowest dose that controls the condition and for gradual reduction. As a cross-check on a big child it also offers fractions of the adult dose - about 75% at 12 years, 50% at 7 years, 25% at 1 year.)

Egyptian National Drug Formulary - Endocrine System Drugs 2024, Prednisolone monograph (printed pages 169-170) - oral, usual initial doses 5 to 60 mg per day given as a single daily dose or in 2 to 4 divided doses, with a worked tapered regimen; general paediatric anti-inflammatory or immunosuppressive dosing, oral, initial 0.1 to 2 mg/kg/day in divided doses 1 to 4 times daily.

The article says severe abdominal pain should prompt consideration of prednisone or prednisolone with a taper, and reports randomised trials in which prednisone shortened the duration and severity of abdominal pain over the first two weeks. It also states plainly that steroid does not prevent renal disease, though it reduces the risk of persistent renal complications in children. The article names the drug without an amount, so the band above is the formulary's general anti-inflammatory band, which is the right band because this is an inflammatory indication.

Diagnose on palpable purpura over the buttocks and legs with a normal platelet count, plus at least one of abdominal pain, joint pain or arthritis, or the kidney involved. Dipstick the urine with microscopy at every visit and keep doing it for six months - renal involvement arrives one to three months after the rash, in 20 to 55 percent of children, and is the commonest cause of serious illness here. Same-day surgical assessment for severe abdominal pain, bloody stool or a palpable mass: intussusception occurs in 3 to 4 percent. Refer a child with persistent proteinuria to a nephrologist.

IgA Vasculitis (Henoch-Schönlein Purpura) - StatPearls (NCBI Bookshelf NBK537252) - https://www.ncbi.nlm.nih.gov/books/NBK537252/

IgA vasculitis usually settles on its own, and the two things that make it dangerous are an abdomen that turns surgical and a kidney that declares itself weeks later. Both are follow-up problems, which is why the urine matters more than any prescription. The article names paracetamol and prednisolone without stating an amount for a child; the amounts printed above come from the product labels, and the steroid stays a specialist decision.

1 g three or four times daily, maximum 4 g in 24 hours - While the joint and abdominal pain lasts - most of it settles within weeks

15 mg/kg/dose [child max 500 mg]

(15 mg/kg per dose three or four times daily from 1 month of age, maximum 60 mg/kg per day. Under 1 month, 10 mg/kg per dose three or four times daily, maximum 40 mg/kg per day. This is mainly a disease of children, so the weight table is the column that will be used.)

MSF Essential Drugs 2024 - paracetamol (oral): adult 1 g 3 or 4 times daily, maximum 4 g daily; child 1 month and over 15 mg/kg 3 or 4 times daily, maximum 60 mg/kg daily; child under 1 month 10 mg/kg 3 or 4 times daily, maximum 40 mg/kg daily. The 500 mg per-dose ceiling is MSF's own top paediatric band, one 500 mg tablet three times daily from 30 to under 50 kg.

The article makes symptomatic and supportive care the foundation of treatment where the kidneys are not involved, and states that acetaminophen or opioids are often preferred over non-steroidal anti-inflammatory drugs for pain control where the gut or the kidney is affected. The distinction matters because the joint pain invites an NSAID, and an NSAID is the wrong drug in a vasculitis that is already bleeding into the bowel wall and inflaming the glomerulus.