What is Henoch Schonlein Purpura?
This is a form of vasculitis that is a grouping of conditions that develops inflammation in the blood vessels. This type of inflammation can cause bleeding in the blood vessels that are small and referred to as capillaries. The capillaries that are affected are in joints, skin, kidneys and intestines. The major indication is a rash that is purplish in color, normally on the lower area of the legs as well as buttocks. This condition also can cause pain in the abdomen as well as joints that ache and with some, kidney complications.
Hennoch-schonlein purpura can touch almost anyone, but it is more common in young adults and children. It normally improves by itself, but if the affected organ is the kidneys – medical management is usually required and follow-ups which is long-term to stop more severe problems from developing.
Henoch Schonlein Purpura Symptoms
Henoch-schonlein purpura has 4 major features, but not every person who has this condition will develop all four. These features include:
Rash or purpura
Spots which are reddish-purple that seem to resemble bruises, normally are the more distinctive as well as universal symptom of Henoch-Schonlein purpura. This rash develops normally on the legs, buttocks as well as feet, although it may also develop on the trunk, arms and face and can in some areas be worse where there is pressure, for example waistline or sock line.
Symptoms of gastrointestinal tract
Approximately half of children with Henoch-schonlein purpura have gastrointestinal symptoms, for example nausea, abdominal pain, bloody stools, or vomiting. These symptoms normally develop within 8 days of developing the characteristic rash.
Sore, swollen joints – Arthritis
Some persons with Henoch-schonlein purpura normally have swollen, painful joints – usually in the ankles as well as knees. Pain in the joint often precedes the classic rash by 1 or 2 days. These are the symptoms that diminish when the condition clears up and there is no lasting damage.
Involvement of Kidney
Approximately 20% to 50% of individuals with Henoch-schonlein purpura develop a certain degree of involvement of the kidneys. This reveals itself in most cases as urine containing blood or protein or both, but the individual will not know until there is a test of the urine. Normally this will go away when the illness goes away, but there are cases where kidney disease can develop and persist.
In many cases, Henoch-schonlein purpura creates problems which are serious of the kidneys or bowel. Individuals should see a physician or child’s physician as quickly as possible when the distinctive rash is noticed as well as other symptoms.
Henoch Schonlein Purpura Causes
With Henoch-schonlein purpura, may of the small blood vessels in the body get inflamed, that can create bleeding in the joints, skin, abdomen as well as kidneys. It is not clear why this initial inflammation develops, but it could be because of an immune system which is overzealous in its inappropriate response to some triggers.
Many of these triggers can include:
- Bacterial and viral infections, for example parvovirus infections as well as strep throat – approximately half of those children with Henoch-Schonlein purpura get sick with this disease following an upper respiratory infection.
- Some medications, such as antihistamines and antibiotics
- Some vaccinations, such as typhoid, measles, cholera as well as yellow fever
- Bites from insect
- Some chemicals
- Weather which is cold
Risk factors for this disease include:
Sex
Henoch-schonlein purpura is normally most common in boys rather than girls
Age
This disease normally affects children and young adults, with the most cases happening in those children between 4 years and 6 years of age
Illness
Having an upper respiratory infection or any other viral or bacterial illness can increase a child’s risk.
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Race
Asian and white children are more likely to develop this condition than black children.
Season
Henoch-schonlein purpura occurs mostly in autumn, spring, and winter but rarely in the summer.
Henoch Schonlein Purpura Diagnosis
The diagnosis of this disease is usually not hard to make because of the rash which is classic, gastrointestinal symptoms and joint pain being present. If there are only 1 to 2 symptoms present, then diagnosis may in some cases be much more challenging.
There is no single lab test to ratify Henoch-schonlein purpura, but definite tests may help in ruling out other problems and to help with making a diagnosis of Henoch-schonlein.
Additionally, after a physical exam and a medical history, the physician might request certain tests, which include:
Blood tests
A level which is elevated of a distinctive protein called IgA can advise Henoch-schonlein purpura, but it is not conclusive. Other indications can be a high erythrocyte sedimentation rate – denoted as sed rate. This measures how fast red blood cells drop to the end in a tube of blood in an hour, and indicates the inflammation level in the body.
Skin biopsy
If there is doubt about the rash or other tests are indecisive, the physician may want a small sample of skin in order to send to the lab to have it examined by microscope looking for the presence of IgA in the blood vessels.
Urine tests
Evaluating kidney function can determine whether this condition is involving the kidneys. It may take months after the rash develops for the kidneys to become involved, so the physician could want to do this test monthly for at least 6 months. If blood is in the urine, as well as raised proteins, your physician will be able to determine how much the kidneys are involved.
Kidney biopsy
Kidney biopsy is a very invasive process, but the physician could request it especially if the symptoms or signs are of kidney involvement which is severe, such as sudden onset of kidney failure or blood pressure which is elevated – especially if these test above are inconclusive. The result of a kidney biopsy may help the physician decide on treatment which is appropriate.
Imaging studies
The physician can also request an ultrasound of the abdomen in order to eliminate other possible reasons of abdominal pain, for example appendicitis or a bowel perforation, or checking for possible difficulties, for example an obstruction of the bowel.
Henoch Schonlein Purpura Treatment
Henoch-Schonlein purpura normally gets better by itself in a few weeks – normally no more than 8 weeks – with no ill effects which are lasting. The treatment is normally aimed at terminating discomfort as well as stopping complications. Often this includes:
- Drink plenty of fluids
- Rest in bed
- Use acetaminophen, or non-steroidal anti-inflammatory drugs such as ibuprofen.
- Be certain to have a child get any follow up urine test as long as the physician recommends it.
Hospitalization
In some circumstances, young adults as well as children with Henoch-Schonlein purpura can need hospitalization. This is normally advised if they have:
- Abdominal pain which is severe or gastrointestinal bleeding
- Trouble keeping well hydrated
- Ulceration of the skin which is extensive
- Symptoms of the joint that causes movement difficulties
- Kidney problems that are serious, that can be treated with immunosuppressive drugs
- Corticosteroids
Using powerful corticosteroids in preventing or treating any complications of Henoch-schonlein purpura is a controversial treatment. It is often used to treat gastrointestinal symptoms which are severe. Since these drugs have serious side effects and the medications usefulness is not clear, be certain to discuss the benefits as well as risks with the physician or pediatrician.
Henoch Schonlein Purpura Pictures
