Henoch-Schonlein Purpura
(Anaphylactoid Purpura, Vascular Purpura)
Definition:
Henoch-Schonlein purpura (HSP) is an inflammation of the blood vessels in the skin and other body organs. Skin involvement often results in a rash, typically occurring on the buttocks and legs. The rash often resembles bruising or bleeding into the skin, a condition referred to as “purpura.”
People of all ages may develop HSP, but it is most common in children.
Causes:
The exact cause of HSP is unknown. It is believed to be a disorder of the immune system. It may be triggered by bacterial or viral infections, certain medications, vaccines, or perhaps even insect bites. HSP frequently occurs in the spring, often after a respiratory infection. It is not contagious.
Risk Factors:
A risk factor is something that increases your chances of getting a disease or condition. Risk factors for HSP include:
- Recent upper respiratory illness, such as a cold
- Age: 2–11
- Recent exposure to vaccines, chemicals, cold weather, or insect bites
- Sex: Male children are twice as likely as females to develop the disease; the risk is equal in adults
Symptoms:
Symptoms may last for 4-6 weeks. Symptoms of HSP may include:
- Skin rash of reddish-purple spots, usually on the buttocks or legs, occasionally on the elbows
- Pain in the joints, especially knees and ankles
- Abdominal pain
- Blood or protein in the urine caused by kidney inflammation
- Swelling of the ankles
- Swelling of the scrotum in males
- Fever
- Blood in the stool
- Vomiting
Diagnosis:
Your doctor will ask about your symptoms and medical history, and perform a physical exam. Tests may include:
- Blood tests
- Urinalysis
- Stool sample
Treatment:
HSP usually gets better on its own. However, under some circumstances your doctor may prescribe specific medications to reduce symptoms and prevent complications. These may include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs)–to lessen joint pain and arthritis
- Cortisone medication–for significant abdominal pain or kidney disease
- Antibiotics–to treat infection
- Cyclophosphamide (Cytoxan)–to suppress the immune system when you have symptoms of severe kidney disease
Prevention:
There are no guidelines for the prevention of HSP. Relapse is predicted in about 50% of cases.
It is important to make sure that you have long-term follow-up visits with your doctor to be sure that kidney disease doesn't develop. |
