Henoch Schonlein Purpura

August 14 20:59 2019 Print This Article

Henoch-Schonlein purpura (HSP or anaphylactoid purpura) is a form of blood vessel inflammation or vasculitis. It is one of the most common forms of vasculitis in childhood. HSP is seen most frequently in children between the ages of 5 and 15 years, and occurs more frequently in boys. A family connection has been noted with HSP, where the disease has happened to two or more siblings of the same family, either at the same time, or one after another.

The symptoms of Henoch-Schonlein purpura usually begin suddenly and may include headache, fever, loss of appetite, cramping abdominal pain, and joint pain. Red or purple spots typically appear on the skin. Inflammatory changes associated with Henoch-Schonlein purpura can also develop in the joints, kidneys, digestive system, and, in rare cases, the brain and spinal cord. In one form of the disorder, termed Schonlein’s purpura, the skin and joints are affected but the gastrointestinal tract is not. In another form, known as Henoch’s purpura, affected individuals have purplish spots on the skin and acute abdominal problems.

People with Henoch’s purpura are not affected by joint disease. The exact cause of Henoh-Schonlein purpura is not fully understood, although research suggests that it may be an autoimmune disease or, in some rare cases, an extreme allergic reaction to certain offending substances (e.g., foods or drugs).

Henoch-Schönlein purpura causes the blood vessels in your skin to get inflamed (irritated and swollen). This inflammation is called vasculitis. It can also affect blood vessels in the bowel and the kidneys. The cause of HSP is unknown. It might be triggered by bacterial or viral infections, medicines, insect bites, vaccinations or exposure to chemicals or cold weather. It occurs most often in the spring, usually after an upper respiratory infection, like a cold. Symptoms include a purple spotted skin rash, abdominal pain and gastrointestinal upsets such as diarrhoea.

Children are most commonly affected, although the condition can develop in adults too. Generally, the older the person, the more severe the symptoms. The condition usually lasts around one to four weeks, and is often marked by relapses. Usually, a child recovers from HSP with no harm done but, in extreme cases, the kidneys are damaged to the point of renal failure.

Causes of Henoch Schonlein Purpura

HSP occurs most often in the spring and frequently follows an infection of the throat or breathing passages. HSP seems to represent an unusual reaction of the body’s immune system which is in response to this infection (either bacteria or virus). HSP occurs throughout the year, but some studies have shown that there is an increase in cases during the fall and winter months.

  • The exact cause of HSP is unknown.
  • Recent exposure to vaccines, chemicals, cold weather, or insect bites.
  • Recent upper respiratory illness, such as a cold.

Signs and Symptoms of Henoch Schonlein Purpura

Sign and symptoms may include the following:

  • Swelling of the joints.
  • Joint pain.
  • Diarrhea.
  • Fever.
  • Other skin rashes, such as hives.
  • Nausea.
  • Vomiting.
  • Painful joints.
  • Abdominal pain.

Treatment for Henoch Schonlein Purpura

There is no specific treatment for HSP. Medicines can help you feel better and treat an infection that may have triggered HSP. Fortunately, HSP usually gets better without any treatment. Antiinflammatory medications, such as aspirin or ibuprofen (Motrin). Some patients can require cortisone medications, such as prednisone, especially those with significant abdominal pain or kidney disease. With more severe kidney disease, cyclophosphamide (Cytoxan) has been used to suppress the immune system. Infection, if present, can require antibiotics.

  • Adequate hydration, or fluid intake.
  • Pain control with medications such as acetaminophen.
  • Antibiotics -to treat infection.
  • Glucocorticoids (to control inflammation).
  • Non-steroidal-anti-inflammatory-drugs (e.g. ibuprofen) are effective at relieving joint and abdominal pain.
  • Careful attention to nutrition.