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Henoch-Schonlein Purpura

Children are susceptible to all kinds of illnesses and infections. Some illnesses, including polio and measles, have been nearly eradicated due to immunization programs. Other infections, including the common cold, circulate around schools and homes and are quite common.

Young immune systems can usually fight off infections without major incident. Occasionally, however, the body over-responds to infection, illness or immunizations by causing inflammation in blood vessels, a condition known as vasculitis.

Henoch-Schonlein purpura (HSP) is a specific type of vasculitis that affects the blood vessels in the skin, joints, intestines and kidneys. While adults can develop HSP, it is more common in children and is most frequently seen in children ages 2 to 11. Girls are less likely to develop HSP than boys.

Henoch-Schonlein Purpura Symptoms

Often, people who have Henoch-Schonlein purpura have recently had an upper-respiratory illness. Symptoms of HSP may be more severe in adults than in children and may include the following:

a purple or reddish rash (purpura) on the skin, generally on the back of the legs, buttocks and elbows, that can last several weeks
fever
joint pain or swelling resembling arthritis
nausea
upset stomach vomiting.

If you or your child develops any of the above-listed symptoms, schedule an appointment with your doctor. She will perform a physical exam to observe skin lesions and to check for joint tenderness. She will also likely perform a urinalysis to check for blood in the urine and blood tests to determine the cause of the vasculitis.

Henoch-Schonlein Purpura Triggers

Researchers don't know the exact cause of HSP. However, most cases seem to be caused when the immune system over-reacts to an upper-respiratory infection. Thus, while the infection that triggers HSP can be passed from one person to another, HSP is not contagious.

Possible HSP triggers include:

antibiotics and antihistamines
insect bites
vaccinations
viral and bacterial infections (e.g., strep throat).

Henoch-Schonlein Purpura Treatment

There is no treatment for Henoch-Schonlein purpura. HSP will usually run its course in a few weeks and generally will leave no lasting complications.

However, there are a few things you can do to ease HSP symptoms. For example, ibuprofen or other non-steroidal anti-inflammatory drugs (NSAIDs) can help with joint pain and can reduce swelling. If your child has HSP, do not give him aspirin to reduce symptoms, as aspirin can cause children to develop Reye's syndrome, a condition that can cause brain and liver damage.

If the symptoms of HSP are severe, your doctor may prescribe a short course of corticosteroids to stop the inflammation and relieve stomach pain.

Henoch-Schonlein Purpura Complications

HSP complications are rare but include:

If HSP affects the bowels, it can cause obstruction, which may require surgery to correct.
In rare cases, HSP may affect the kidneys. In fact, in extreme cases, HSP can cause kidney failure.
Kidney problems generally show up after the HSP symptoms have resolved, sometimes as long as six months after the onset of HSP. To make sure your kidneys are functioning properly, your doctor may want you to come in regularly for urine tests.
There is a possibility that someone who has had Henoch-Schonlein purpura will develop it again. Approximately one-third of people who have HSP will get it at least once more.

Resources

Mayo Clinic staff (2006). Henoch-Schonlein Purpura. Retrieved September 21, 2007, from the Mayo Clinic Web site: http://www.mayoclinic.com/health/henoch-schonlein-purpura/DS00838.

National Institutes of Health (n.d.). Vasculitis. Retrieved September 21, 2007, from the National Heart Lung and Blood Institute Web site: http://www.nhlbi.nih.gov/health/

dci/Diseases/vas/vas_all.html.

The Cleveland Clinic (2004). What You Need to Know About Henoch-Schonlein Purpura (HSP). Retrieved September 21, 2007, from the ClevelandClinic.org Web site: http://www.clevelandclinic.org/arthritis/treat/facts/hsp.htm.