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Henoch-Schönlein Purpura (HSP)

What is Henoch-Schönlein purpura?

Henoch-Schönlein purpura (HSP) is a form of vasculitis. Vasculitis is a condition that involves inflammation of the blood vessels. It is one of the most common forms of vasculitis in children. HSP is seen most often in children between the ages of 2 and 6. It occurs more often in boys. The disease can happen in siblings of the same family. Most children with HSP recover fully.

What causes Henoch-Schönlein purpura?

HSP is an autoimmune disorder. This when the body’s immune system attacks the body’s own cells and organs. This immune response may be caused by an upper respiratory tract infection, allergic reaction, medication, trauma, or exposure to cold weather.

What are the symptoms of Henoch-Schönlein purpura?

Symptoms can occur a bit differently in each child. Common symptoms include:

  • Bleeding into the skin, mucous membranes, internal organs, and other tissues (purpura)
  • Pain in the joints (arthralgia)
  • Inflammation of the joints
  • Abdominal pain
  • Bleeding in the gastrointestinal, or GI, tract, which includes the mouth, esophagus, stomach, and intestines.
  • Inflammation of the kidneys (nephritis)
  • Swelling just below the skin (subcutaneous edema)
  • Dysfunction of the brain (encephalopathy)
  • Inflammation of the testicles (orchitis)

The symptoms of HSP can be like other health conditions. Make sure your child sees his or her health care provider for a diagnosis.

How is Henoch-Schönlein purpura diagnosed?

The process starts with a medical history and a physical exam. Diagnosis is based on symptoms such as:

  • Arthritis
  • Bleeding into the skin, mucous membranes, internal organs, and other tissues (purpura)
  • Abdominal pain
  • Kidney disease

Tests may also be done, such as:

  • Biopsy. Small pieces of tissue may be taken. They are looked at with a microscope.
  • Ultrasound. This is a tool that uses sound waves and a computer to make images of blood vessels, tissues, and organs. It may be used to look at the GI tract for signs of the disease.

How is Henoch-Schönlein purpura treated?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Treatments for HSP may include:

  • Making sure your child drinks enough fluids
  • Making sure your child eats a healthy diet
  • Medications such as acetaminophen to help lessen pain
  • Glucocorticoids to control inflammation
  • Blood pressure medication to lower blood pressure if needed

Talk with the healthcare providers about the risks, benefits, and possible side effects of all medications.

What are the complications of Henoch-Schönlein purpura?

Most children with HSP recover fully. However, some children may develop kidney damage. In rare cases, a child may have kidney failure. Women who have had HSP as a child have a higher risk of pregnancy-induced hypertension.

When should I call my child’s healthcare provider?

If your child’s symptoms get worse or he or she has new symptoms, let the healthcare provider know.

Key points about Henoch-Schönlein purpura

  • Henoch-Schönlein purpura is a form of vasculitis, a condition that involves inflammation of the blood vessels.
  • It is seen most often in children between the ages of 2 and 6. It occurs more often in boys.
  • HSP is an autoimmune disease that is often triggered by an upper respiratory infection
  • Symptoms of HSP include arthritis, bleeding under the skin (purpura), abdominal pain, and kidney disease.
  • Treatment options include fluids, nutrition, pain control, and other medications.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.
Online Medical Reviewer: Foster, Sara, RN, MPH
Online Medical Reviewer: Freeborn, Donna, PhD, CNM, FNP
Date Last Reviewed: 4/10/2014
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