Sir.—We read with interest the report of Maggiore et al1 about the association between hepatitis B virus infection and Schönlein-Henoch purpura. Recently, we have seen a child with a simultaneous appearance of Schönlein-Henoch purpura and hepatitis A virus (HAV) infection.
Report of a Case.—An 8-year-old boy, whose brother had icteric infectious hepatitis five weeks earlier, was hospitalized because of pain, swelling, and dark discoloration of the right side of the scrotum. Within the next few days purpuric rash, characteristic of Schönlein-Henoch purpura, appeared on his penis, buttocks, and lower extremities. Physical examination also revealed an enlarged liver and spleen that were palpated 4 and 2 cm under the costal margin, respectively. There was no visible jaundice. Laboratory investigation disclosed the following values: an increase of aspartate aminotransferase (serum glutamic-oxaloacetic transaminase), more than tenfold the upper normal value; total bilirubin, 2.4 mg/dL; IgG, 2,510 mg/dL; IgM, 114 mg/dL;