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Read MoreHenoch-Schonlein Purpura: Causes, Symptoms, Diagnosis, and Treatment
Key Takeaways
- This autoimmune vasculitis peaks between ages 2-11 with a 2:1 male predominance, often triggered by upper respiratory infections, cold weather exposure, or certain medications and foods.
- The hallmark purpuric rash appears as raised, non-blanching purple spots primarily on legs and buttocks, accompanied by joint swelling in knees and ankles in 75% of cases.
- Abdominal cramping affects two-thirds of patients and can be severe enough to mimic appendicitis, while kidney involvement occurs in 20-50% of children within the first month.
- Most episodes self-resolve within 4-6 weeks using supportive care with NSAIDs or acetaminophen; corticosteroids are reserved for severe abdominal pain or significant kidney involvement.
- Long-term kidney monitoring is crucial since 5% develop progressive chronic kidney disease and 1% may progress to kidney failure, particularly those with persistent proteinuria or hematuria.
Henoch-Schonlein Purpura (HSP) is a disease that causes inflammation of small blood vessels, leading to leaking in the skin, intestines, kidneys, and joints. It most commonly affects children, particularly boys, between the ages of 2 and 11. Adults who develop HSP generally experience more severe cases.
Symptoms of Henoch-Schonlein Purpura
The classic symptoms of HSP include:
Rash: A raised, bruise-like rash over the legs or buttocks that affects both sides of the body equally.
Joint pain and swelling: Inflammation of the joints, particularly the knees and ankles, lasting a few days.
Abdominal pain: Pain or cramping in the gastrointestinal tract, which may lead to loss of appetite, vomiting, or diarrhea.
Kidney problems: Mild kidney impairment, indicated by protein or blood in the urine, which usually resolves without long-term damage.
Before these symptoms appear, patients may experience fever, headache, and muscular aches and pains for two to three weeks.
Causes and Risk Factors for Henoch-Schonlein Purpura
The exact cause of HSP is unknown, but it is believed to involve an abnormal immune response targeting the blood vessels. Some potential triggers include:
Upper respiratory tract infections
Vaccinations (typhoid, cholera, yellow fever, measles, or hepatitis B)
Certain foods, drugs, chemicals, or insect bites
Colder weather during fall and winter
Diagnosing Henoch-Schonlein Purpura
HSP can often be diagnosed based on the presence of the typical rash, arthritis, and abdominal pain. However, doctors may perform additional tests to rule out other conditions, confirm the diagnosis, and assess the severity of the disease. These tests may include:
Skin or kidney biopsies
Urine and blood tests to monitor kidney function
Treatment Options for Henoch-Schonlein Purpura
There is no specific treatment for HSP, but over-the-counter pain medications like acetaminophen or NSAIDs can help manage joint pain. In some cases, corticosteroid medication may be prescribed. The rash and joint pain usually resolve within four to six weeks without causing permanent damage.
It is essential to monitor kidney function closely, as about 5% of patients may develop progressive kidney disease, and 1% may experience total kidney failure. Regular follow-up with a healthcare provider is crucial to prevent serious complications.
For more information on Henoch-Schonlein Purpura, consult the following reputable sources:
The Bottom Line
While this childhood vasculitis typically resolves on its own within 6 weeks, the potential for serious kidney complications requires ongoing medical supervision and urine monitoring. Early recognition of the characteristic rash pattern and associated symptoms allows for prompt supportive treatment and appropriate follow-up care. If you're concerned about unexplained rashes or related symptoms in your child, Doctronic can help you understand when to seek immediate medical attention.
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