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Henoch-Schonlein purpura (HSP) is a form of vasculitis or inflammation of the blood vessels. HSP affects the capillaries in the skin causing bleeding which appears as a purplish rash most commonly on the buttocks and lower legs. Sometimes joint pain or abdominal pain accompanies it and HSP commonly affects the kidneys.
Henoch-Schonlein purpura most often occurs in the spring after the person has had a bacterial or viral upper respiratory infection. It is thought that HSP is the result of an immune reaction after the illness though drugs or certain vaccinations can also trigger a HSP response.
Henoch-Schonlein purpura occurs most commonly in children and young adults. Medicine.net says that it is a mild illness that generally resolves on its own in about a month unless there are kidney or bowel complications requiring further treatment.
According to Mayoclinic.com, there are four main characteristics of Henoch-Schonlein purpura though not everyone develops all four symptoms:
• A rash (purpura) appears which look like red/purple bruises and is the “universal” sign that someone has Henoch-Schonlein purpura. The main site is the buttocks and legs and feet but can appear on the arms, face or trunk.
• Painful or swollen joints, particularly of the knees and ankles, may develop one to two days before a rash appears. Joint symptoms usually clear after recovery from HSP.
• Gastrointestinal symptoms such as abdominal pain, nausea, vomiting and bloody diarrhea may develop. GI symptoms occur in over 50 percent of children with HSP. In rare cases, a bowel obstruction can occur.
• Kidney involvement occurs in roughly 20 to 50 percent of those with HSP. Blood and or protein in the urine may be found with urine testing that is not apparent to the eye.
Kidney symptoms usually resolve after recovery from HSP but in some cases further kidney disease may develop. In some cases HSP damages the kidney and the person develops end stage renal failure requiring dialysis or a kidney transplant. Adults are at greater risk than children.
Diagnosis
A doctor may have blood tests drawn that show inflammation in the body but this lab work will not conclusively diagnose HSP. Urine testing to check for blood and protein may also be performed and continue to be checked for several months afterwards to monitor the kidney, since damage may not show up right away. A kidney biopsy may be performed if kidney involvement is apparent to help plan for appropriate treatment.
Other tests may be performed to confirm whether the symptoms are related to another medical problem. A skin biopsy will show if there are inflammatory cells around the blood vessels. Imaging studies can rule out whether gastrointestinal symptoms may be due to another cause such as appendicitis.
Treatment
Basic treatment involves bedrest, increased liquids and Tylenol or NSAID as needed for joint pain. Sometimes corticosteroids are used for those with abdominal pain or kidney disease. If more kidney involvement is found, stronger medications may be required to suppress the immune system.
Overall, the recovery is reported to be very good for both children and adults of Henoch-Schonlein purpura. Sometimes there is a recurrence of the rash months after the illness, or even a recurrence of the illness in children who have had severe symptoms. However, repeat bouts are usually milder than the initial episode.
Sources:
Henoch-Schonlein purpura. Mayoclinic.com. Retrieved Mar. 18, 2012.
http://www.mayoclinic.com/health/henoch-schonlein-purpura/DS00838/METHOD...
Henoch-Schonlein Purpura (HSP)
Or Anaphylactoid Purpura. Retrieved Mar. 18, 2012.
http://www.medicinenet.com/henoch-schonlein_purpura/article.htm
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele are at www.helium.com/users/487540/show_articles
Edited by Jody Smith
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