Henoch-Schönlein Purpura

This is a soreness (inflammation) of the blood vessels and/or capillaries. It is seen as red to purple spots on the skin. These can usually be felt as a raised rash. It usually occurs in the fall, winter and spring but rarely in the summer. There may also be joint pain (around the knees and ankles), belly (abdominal) pain, and kidney problems. It usually occurs in children ages 3 to 15, but adults may also be affected. It is more common in boys. The rash will usually show up on the legs and buttocks. This happens before other problems such as abdominal pain and arthritis (inflammation of the joints). The rash can spread to the face and body (trunk).

CAUSES

The cause is not known. It may be an abnormal response by the immune system. That is the system which usually keeps us from getting sick. It is sometimes seen with or following allergies, drug sensitivities, vaccinations and infections.

SYMPTOMS

  • Primarily, redness and swelling of the skin caused by congestion of the capillaries.

  • Lack of energy.

  • Joint pains.

  • Abdominal pain.

  • Bloody stools.

  • Purple spots (wheals) - usually on the lower extremities and buttocks, but may involve elbows, trunk, and face.

  • Low-grade fever.

  • Nausea/vomiting.

  • Diarrhea.

  • Bloody urine.

DIAGNOSIS

  • Your caregiver can diagnose this condition based on an examination. He/she also may do some blood and urine tests.

  • Biopsies are sometimes done. In this test, a small piece of tissue (your skin) is taken to be examined by a specialist under a microscope. This is used to help confirm a diagnosis if there is uncertainty.

TREATMENT

  • Treatment is directed at symptoms or along with your caregiver you may just watch and see. There are not any specific treatments available.

  • This condition usually resolves spontaneously within 6 to 16 weeks without treatment. But it may recur several times before complete remission.

  • Bed rest.

  • Drink plenty of fluids as suggested by your caregiver to avoid dehydration.

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen maybe used for aches and fever as directed by your caregiver. Only take over-the-counter or prescription medicines for pain, discomfort, or fever as directed by your caregiver.

  • Corticosteroid therapy may be used for the central nervous system problems, kidney (nephritic) syndrome, or complications, such as intestinal hemorrhage, obstruction, or perforation.

  • Medications are available to treat kidney complications.

  • Most children get well. But some children can develop kidney failure (end stage renal disease).

COMPLICATIONS

  • Bleeding in the lungs (pulmonary hemorrhage).

  • Bleeding into the intestines (intestinal hemorrhage).

  • Food is blocked from going through the intestines (intestinal obstruction).

  • There is a telescoping of the small intestine (bowel) on itself (intussusception).

  • A hole in the intestines (intestinal perforation).

  • Death can occur from gastrointestinal complications, renal failure, or central nervous system involvement. These bad outcomes are very rare.

SEEK IMMEDIATE MEDICAL CARE IF:

  • There is severe abdominal pain or nausea and vomiting.

  • There is severe headache or joint pain not relieved with medicine.

  • There is blood in the urine or urination stops.

  • There is increasing swelling and pain in the joints.

  • Your child feels lightheaded or faint.