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Clinical Services at Rush Types of Vasculitis

Henoch-Schönlein purpura (HSP)

What is the cause of Henoch-Schönlein purpura?
What are the symptoms of Henoch-Schönlein purpura?
How is the diagnosis of Henoch-Schönlein purpura made?

What is the treatment for Henoch-Schönlein purpura?
What is the prognosis for Henoch-Schönlein purpura?

   
Henoch-Schönlein purpura (anaphylactoid purpura; vascular purpura) causes inflammation of blood vessels in the skin, joints, intestines and kidneys. The main symptom is a purplish rash, typically on the lower legs and buttocks. Henoch-Schönlein purpura also often causes abdominal pain and aching joints, and, in some people, kidney problems.

Henoch-Schönlein purpura is most commonly found in children between
4 and 6 years old and in young adults. This disorder usually improves on its own, but if the kidneys are affected, medical care is generally needed, as well as long-term follow-up to prevent complications.

What is the cause of Henoch-Schönlein purpura?

The cause of Henoch-Schönlein purpura is unknown, but it is an autoimmune disease whereby the immune system attacks the body’s own cells. Some possible triggers for this response include:

  • Viral and bacterial infections, such as strep throat and parvovirus infection
  • Certain medicines, including some antibiotics and antihistamines
  • Insect bites
  • Some vaccinations, including those for measles, typhoid, yellow fever and cholera
  • Cold weather
  • Certain chemicals

What are the symptoms of Henoch-Schönlein purpura?

There are four main characteristics of Henoch-Schönlein purpura, although not everyone with the disease develops all four. They include:

  • Reddish-purple rash (purpura)
  • Swollen, sore joints, mainly in knees and ankles
  • Abdominal pain, nausea, vomiting, diarrhea or bloody stools
  • Kidney involvement (glomerulonephritis)

How is the diagnosis of Henoch-Schönlein purpura made?

A diagnosis is fairly easy to make when the classic rash, joint pain and gastrointestinal symptoms are present. If only one or two are present, diagnosis can be more of a challenge.

Although no single laboratory test can confirm Henoch-Schönlein purpura, certain tests can help rule out other diseases and make a diagnosis of Henoch-Schönlein seem likely.

In addition to a physical exam and medical history, useful laboratory tests may include:

  • Blood tests
  • Erythrocyte sedimentation rate (ESR)
  • Urine tests
  • Skin biopsy
  • Kidney biopsy
  • Imaging studies

What is the treatment for Henoch-Schönlein purpura?

There is no specific treatment for HSP, and most cases go away on their own in less than eight weeks. To relieve discomfort and prevent complications, bed rest, drinking plenty of fluids and the use of acetaminophen (Tylenol) or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) may be useful, especially when there is no kidney involvement. If symptoms persist, therapy with a corticosteroid such as prednisone may be considered, although the serious side effects make this controversial.

What is the prognosis for Henoch-Schönlein purpura?

In general, the disease usually resolves itself without treatment. The most serious complication of Henoch-Schönlein purpura is kidney damage, but even most patients with kidney problems recover fully. A woman who had Henoch-Schönlein purpura as a child may be at increased risk of high blood pressure during pregnancy and should be monitored appropriately.





Contact Name
Rush Vasculitis Clinic
Contact Phone
(312) 563-2800
Contact E-mail
contact_rush@rush.edu



Location
Orthopedic Building
1611 W. Harrison St., Suite 510
Chicago, IL 60612



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