Which of the following symptoms is NOT typically associated with Henoch Schonlein Purpura?

Henoch-Schönlein Purpura (HSP), also known as IgA vasculitis, is a common form of small-vessel vasculitis seen in children. It is characterized by a tetrad of symptoms that typically includes a purpuric rash, abdominal pain, arthralgia or arthritis, and renal involvement.

The purpuric rash in HSP is specifically often located on the buttocks and legs, which is a hallmark symptom. Abdominal pain is also common due to vasculitis affecting the mesenteric vessels. Joint pains, or arthralgia, occur due to inflammation in the joints associated with the autoimmune response.

However, nephrotic syndrome is not typically associated with HSP. While renal involvement can occur, it usually manifests as hematuria and proteinuria, which might suggest nephritis. Nephrotic syndrome is specifically characterized by significant proteinuria (>3.5 g/day), hypoalbuminemia, and edema, which is not a standard feature of HSP.

Understanding the classic symptoms associated with HSP is crucial for diagnosis and differentiating it from other conditions that may present similarly.