{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T14:46:27Z","timestamp":1775486787857,"version":"3.50.1"},"reference-count":41,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T00:00:00Z","timestamp":1582761600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Pediatric Dermatology"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Hypergammaglobulinemic purpura of Waldenstr\u00f6m (HGPW), a rare cutaneous eruption characterized by the triad of recurrent episodes of lower extremity petechiae, symptoms of stinging and burning, and lower extremity edema, is poorly described in children. Some children have been reported to follow a benign course, while others are eventually diagnosed with fulminant rheumatologic disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine the distinguishing features of HGPW including the spectrum of disease manifestations and clinical outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This is a multicenter, retrospective case series of six children with HGPW combined with a literature review of 45 previously published pediatric cases.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Most children were eventually diagnosed with systemic disease (63%) or developed autoantibody accumulation suggestive of evolving disease (71%). The most common diagnoses were Sjogren's syndrome and systemic lupus erythematosus. The mean duration between onset of cutaneous eruption and diagnosis of systemic disease was 5.6\u00a0years, underscoring that HPGW patients often present with a rash that precedes the development of systemic symptoms.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Diagnosis of HGPW should prompt initial screening for rheumatologic disease with long\u2010term rheumatology follow\u2010up, as the majority of patients present with evolving manifestations of systemic disease.<\/jats:p><\/jats:sec>","DOI":"10.1111\/pde.14120","type":"journal-article","created":{"date-parts":[[2020,2,27]],"date-time":"2020-02-27T11:43:45Z","timestamp":1582803825000},"page":"467-475","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Hypergammaglobulinemic purpura of Waldenstr\u00f6m in children"],"prefix":"10.1111","volume":"37","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1864-0594","authenticated-orcid":false,"given":"Erin","family":"Theisen","sequence":"first","affiliation":[{"name":"Department of Dermatology University of Wisconsin School of Medicine and Public Health Madison Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dylan E.","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Dermatology Department of Internal Medicine The Ohio State University Wexner Medical Center Columbus Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susan","family":"Pei","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Wisconsin School of Medicine and Public Health Madison Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David M.","family":"Schauder","sequence":"additional","affiliation":[{"name":"Medical College of Wisconsin Milwaukee Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2869-2718","authenticated-orcid":false,"given":"Yvonne E.","family":"Chiu","sequence":"additional","affiliation":[{"name":"Departments of Dermatology (Pediatric Dermatology) and Pediatrics Medical College of Wisconsin Milwaukee Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Heather","family":"Brandling\u2010Bennett","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Washington Seattle Washington"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Megan L.","family":"Curran","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Colorado Aurora Colorado"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marisa","family":"Klein\u2010Gitelman","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Northwestern University Feinberg School of Medicine Chicago Illinois"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominic O.","family":"Co","sequence":"additional","affiliation":[{"name":"Department of Pediatrics University of Wisconsin School of Medicine and Public Health Madison Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lisa M.","family":"Arkin","sequence":"additional","affiliation":[{"name":"Department of Dermatology University of Wisconsin School of Medicine and Public Health Madison Wisconsin"},{"name":"Department of Pediatrics University of Wisconsin School of Medicine and Public Health Madison Wisconsin"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2020,2,27]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"518","article-title":"Hypergammaglobulinemic purpura of Waldenstr\u00f6m: report of 3 cases with a short review","volume":"18","author":"Malaviya AN","year":"2000","journal-title":"Clin Exp Rheumatol"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10067-008-1038-2"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s100670070017"},{"key":"e_1_2_6_5_1","first-page":"225","article-title":"Hypergammaglobulinemic purpura in childhood. 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