Henoch-Schönlein purpura : Causes-Symptoms-Diagnosis-Treatment

 What Is Henoch-Schönlein purpura (HSP)?

Henoch-Schonlein purpura (HSP) could be a disease involving inflammation of tiny blood vessels. It most typically happens in youngsters. The inflammation causes blood vessels within the skin, intestines, kidneys, and joints to begin leaking. The most common symptom is a rash with various small bruises that have a raised appearance, over the legs or buttocks.Although HSP will have an effect on individuals at any age, most cases occur in children between the ages of two and 11. It's more common for boys than girls. Adults with HSP are more likely to have a more severe disease compared to children.

What Is Henoch-Schönlein purpura (HSP)?
Henoch-Schönlein purpura

HSP sometimes ends after four to 6 weeks -- generally with repetition of symptoms over this period, however with no semi permanent consequences (recurrences are fairly common). If organs adore the kidneys and intestines are affected, treatment is usually required and it's necessary to own regular follow-up to stop serious complications.Henoch-Schönlein blood disease (HSP) could be a rare disease of the tiny blood vessels (capillaries) and is usually a end disease. It's the foremost common type of childhood tube inflammation (vasculitis) and ends up in inflammatory changes within the small blood vessels. The symptoms of HSP usually begin suddenly and should embrace headache, fever, loss of appetite, cramping, abdominal pain, painful menstruation, hives, bloody diarrhea, and joint pain. Red or purple spots usually seem on the skin (petechiae). Inflammatory changes related to HSP also can develop within the joints, kidneys, organic process system, and, in rare cases, the brain and neural structure (central nervous system).

In one type of the disorder, termed Schönlein’s purpura, the skin and joints are affected however the GI tract is not. In another form, referred to as Henoch’s purpura, affected people have purple spots on the skin and acute abdominal problems, adore Bright's disease (a type of kidney disorder). individuals with Henoch’s blood disease don't seem to be plagued by joint disease.

The precise reason for HSP isn't absolutely understood, though analysis demonstrates that it's involving Associate in Nursing abnormal response by the system or, in some rare cases, an extreme hypersensitive reaction to sure violative substances (e.g., foods or drugs).

  1. Arteries

  2. Veins

  3. Blood vessels

Medical terms

  • Henoch-Schonlein purpura (also known as IgA vasculitis) is a disorder that causes the tiny blood vessels in your skin, joints, intestines and urinary organs to become inflamed and bleed. The foremost hanging feature of this type of rubor may be a chromatic rash, usually on the lower legs and stock. Henoch-Schonlein blood disease may also cause abdominal pain and aching joints. Rarely, serious kidney injury can occur. Henoch-Schonlein purpura can have an effect on anyone, but it's most typical in youngsters beneath 10. The condition usually improves on its own. Medical aid is mostly required if the disorder affects the kidneys. 
  • Henoch-Schönlein purpura (HSP) is a common usually painless condition that causes small purplish skin and joint bruises HSP often develops after a child's first infection with an intestinal virus or Bordetella pertussis Bacterial infections of the respiratory tract and urogenital tract also may trigger HSP In 1 in 10 cases no known cause can be found for the disease.
  • – Symptoms Causes and Treatment Henoch-Schonlein purpura (HSP) is a disease that causes blood vessel inflammation and bleeding This condition occurs most commonly in children between the ages of 6 months and 12 years HSP often produces symptoms in the joints skin and kidneys The kidneys are affected by this disease when there is bleeding in the small blood vessels that filter waste products from the blood Kidney damage can occur during an attack or it can happen later on as a result of long-term kidney problems caused by HSP HSP most commonly affects children who have other health issues such as asthma or allergies.

Symptoms Henoch-Schönlein purpura (HSP)

The symptoms of HSP usually begin suddenly. in addition to the characteristic red recognizing of the skin (most typically on the buttocks and backs of the legs), they will embody headache, loss of appetite, and/or fever. The skin typically becomes red (diffuse erythema). Cramping abdominal pain may occur and is typically most severe throughout the night. Blood is also gift within the stool and abnormal harm (hemorrhaging) from the willall|alimentary tract|digestive tube|digestive tract|GI tract|duct|epithelial duct|canal|channel} can cause bloody diarrhea. Joint pain (arthralgia) may develop in any joint of the body, particularly the knees and ankles. Some folks with HSP expertise inborn reflex and diarrhea; others may have severe constipation and unco dark stool (melena). People with HSP usually develop little red or purple spots (petechiae) on the skin, particularly on the legs. These blood disease spots are caused by small hemorrhages beneath the skin and don't seem to be related to abnormally low levels of platelets (nonthrombocytopenic) as is common with other styles of purpura. Different skin lesions associated with HSP embody massive hives (urticarial wheels) or ulcers (necrotic), especially on the buttocks and legs. Swelling could occur within the face and neck thanks to abnormal fluid accumulation in the soft tissues of those areas (angioneurotic dropsy). In rare cases, swelling and edema within the throat can cause respiratory difficulties that may cause dangerous metabolism issues. Between one-quarter and a simple fraction of individuals with HSP have problems with excretory organ function, comparable to glomerulonephritis, during which the portion of the kidney that separates waste from the blood is damaged. Blood in the piss (hematuria) and inflammatory changes in the kidneys might also develop. Some people may develop severe kidney disease, as well as immunoglobulin G nephropathy, chronic inflammation of the kidneys (nephritis), and/or nephrosis resulting in kidney failure. In rare cases, a portion of the affected person’s intestine or intestine could fold in upon itself (intussusception). This will end in substantial pain and, if conservative measures don't resolve the problem, surgery is also required.

The four main characteristics of Henoch-Schonlein purpura include:

  • Rash (purpura). Reddish-purple spots that seem like bruises develop on the buttocks, legs and feet. The rash may also seem on the arms, face and trunk and should be worse in areas of pressure, akin to the sock line and waistline. 

  • Swollen, sore joints (arthritis). People with Henoch-Schonlein purpura frequently have ache and swelling across the joints — mainly in the knees and ankles. Joint pain occasionally precedes the classical rash by means of one or  weeks. These symptoms subside whilst the disease clears and departs no lasting damage.

  • Digestive tract symptoms. Many kids with Henoch-Schonlein purpura broaden their belly pain, nausea, vomiting and bloody stools. These symptoms every so often arise before the rash seems.

  • Kidney involvement. Henoch-Schonlein blood disorder may also have an effect on the excretory organs. In most cases, this shows up as supermolecule or blood within the piddle, that you will not even grasp is there unless you have got a urine check done. Sometimes this goes away once the sickness passes, however some folks develop persistent kidney disease. 

When to see a doctor

See your doctor if you have got Henoch-Schonlein blood disease and it's inflicting serious issues together with your biological process tract. If your kid develops a rash related to this condition, see your doctor as presently as possible. 

Causes Henoch-Schönlein purpura (HSP)

The exact reason behind HSP isn't known, though analysis suggests that this sickness additionally be|is also} caused by system pathology (i.e., enhanced Ig immune complexes). response disorders are caused once the body’s natural defenses against “foreign” or incursive organisms (e.g., associated antibodies) begin to attack healthy tissue for unknown reasons. In some cases, it's been advised that this disorder may be an extreme aversion to bound foods, reminiscent of chocolate, milk, eggs, or beans. numerous medicine (e.g., nifedipine, diltiazem, cefuroxime, diclofenac, etc.), microorganism (e.g., Streptococcus), and bug bites have also been indicated as doable causes in some cases. morbilli precedes the primary symptoms of  HSP in concerning thirty p.c of cases. In about sixty six percent of cases, an higher respiratory tract infection precedes the onset of symptoms by about one to three weeks. an explicit link to microorganism infections has not been proven.In Henoch-Schonlein purpura, a number of the body' little blood vessels become inflamed, which might cause hurt within the skin, abdomen and kidneys. It's not clear why this primary inflammation develops. it should be the results of the system responding unsuitably to certain triggers. Nearly the folks that have Henoch-Schonlein blood disorder developed it when they associate higher metabolism infection, reminiscent of a cold. Different triggers embrace chickenpox, strep throat, measles, hepatitis, bound medications, food, insect bites and exposure to cold weather.

Risk factors Henoch-Schönlein purpura (HSP)

The exact reason for HSP isn't known. The body' system is believed to play a role in targeting the blood vessels involved. Associate in Nursing abnormal response to an infection conjointly be|is also} an element in several cases. A close to common fraction of the cases of HSP occur days when symptoms of a higher tract infection develop. Some cases of HSP are connected to vaccinations for typhoid, cholera, yellow fever, measles, or liver disease B; foods, drugs, chemicals, and bug bites. Some consultants also say that HSP is related to the colder weather of fall and winter.

Factors that increase the risk of developing Henoch-Schonlein purpura include:

  • Age. The disease mainly affects children younger than 10.

  • Sex. Henoch-Schonlein purpura is slightly more common in males than in females.

  • Race. White and Asian children are more likely to develop Henoch-Schonlein purpura than are black children.

Is Henoch Schonlein Purpura genetic?

Henoch-Schönlein purpura (HSP) is a systemic vasculitis of unknown cause that primarily affects the small vessels of the gastrointestinal tract and kidneys HSP is a disease that runs in families and there is a strong genetic link A study done by Dr George L Bakris at the University of Chicago found that two thirds of HSP patients had children with the condition after studying 500 families with known hereditary patterns of HSP.

Can you get Henoch Schonlein Purpura twice?

While Henoch Schonlein Purpura is not a hereditary disease meaning it cannot be passed down from parent to child it can occur more than once in the same family.

Is HSP life-threatening?

Not at all Hypersensitive people may have symptoms that are uncomfortable and annoying but they aren't life-threatening.

Is HSP a lifelong disease?

HSP is a lifelong disease It can however be managed with lifestyle changes and medications if it becomes severe enough There are three main types of HSP: Hereditary sensory and autonomic neuropathy (HSAN) – This type of HSP affects the nerves that control senses like touch and pain as well as motor functions like balance and coordination HSAN symptoms may begin in infancy or childhood but they often develop over time Symptoms include difficulty walking muscle weakness (particularly in the legs) decreased sensitivity to touch hearing problems and learning disabilities The most common form of HSAN is known as hereditary sensory neuropathy (HSN1) Approximately 95.

Can adults get Henoch-Schonlein purpura?

Henoch-Schonlein purpura can affect people of any age but it often occurs in children ages 5 to 15. The symptoms usually go away on their own within a few weeks In rare cases the condition may be life-threatening.

Is Henoch-Schonlein autoimmune?

The Henoch-Schonlein purpura is an autoimmune disease that affects small blood vessels throughout the body particularly in the skin kidneys and joints This condition is characterized by a sudden onset of symptoms such as arthritis and abdominal pain that causes red and purple skin rashes with small raised dots on the back of the legs (a characteristic known as "purpura") The most common symptoms are painful joints or abdomen caused by severe inflammation of blood vessels in those areas.

Complications Henoch-Schönlein purpura

For most people, symptoms improve at intervals a month, leaving no lasting problems. However recurrences are fairly common. Complications related to Henoch-Schonlein blood disorder include:

  • Kidney damage. The most serious complication of Henoch-Schonlein blood disease is urinary organ injury. This risk is larger in adults than in children. Often the damage is severe enough that qualitative analysis or a kidney transplant is needed. 

  • Bowel obstruction. In rare cases, Henoch-Schonlein peliosis will cause intussusception — a condition within which a district of the intestine folds into itself sort of like a telescope, which prevents matter from moving through the bowel. 

Diagnosis Henoch-Schönlein purpura (HSP)

The designation of  HSP could also be difficult, particularly in adults. The malady is often confused with alternative styles of vascular  inflammation (see connected Disorders section of this report). Routine laboratories take a look at which are usually not definitive for the disorder. The protoplasm count is usually traditional though white somatic cell and alleviation rates may be elevated. The disorder is diagnosed by a mix of the presence of skin lesions and/or joint tenderness, combined with a confirmed test for blood within the water (urinalysis), and a skin diagnostic assay that shows inflammation of the blood vessel and blood vessel capillaries.Your doctor can be ready to diagnose the condition as Henoch-Schonlein peliosis if the classic rash, joint pain and duct symptoms are present. If one in all these signs and symptoms is missing, your doctor could recommend one or a lot of the subsequent tests.

Lab tests

No single laboratory to take a look at will ensure Henoch-Schonlein purpura, however bound tests can facilitate rule out different diseases and create a diagnosing of Henoch-Schonlein appear likely. they'll include:

  • Blood tests. Your blood may be tested if your diagnosis isn't clear based on your signs and symptoms.

  • Urine tests. Your urine may be tested for evidence of blood, protein or other abnormalities to determine if your kidneys are still working properly.


People who have Henoch-Schonlein blood disorder often have deposits of an exact protein, IgA (immunoglobulin A), on the affected organ. Your doctor could take a little sample of skin in order that it will be tested in an exceedingly lab. In cases of severe urinary organ involvement, your doctor may recommend a kidney diagnostic test to assist guide treatment decisions.

  1. Immunologic blood test

Imaging tests

Your doctor might suggest associating ultrasound to rule out different causes of abdominal pain and to examine for attainable complications, equivalent to an internal organ obstruction.

Treatment Henoch-Schönlein purpura (HSP)

Occasionally, once the diagnosis is uncertain, significantly if the sole symptom is that the classic rash, your doctor may perform biopsies of the skin or urinary organ. excretion and blood tests can seemingly be done to observe signs of kidney involvement and will have to be compelled to be recurrent throughout follow-up to observe any changes in kidney function. Though there's no specific treatment for HSP, you'll be able to use over-the-counter pain medicines, comparable to Panadol or NSAID medicine (NSAIDs), such as Motrin and nonsteroidal anti-inflammatory for joint pain. In some cases, sex hormone medication is also used. The rash and joint pain can typically escape once four to 6 weeks while not inflicting any permanent damage. Bouts of the rash could recur in or so common fraction of cases, however usually they're  milder, don't involve joint and abdominal symptoms, and that they clear au courant their own.Henoch-Schonlein blood disorder usually goes away on its own inside a month with no lasting ill effects. Rest, lots of fluids and over-the-counter pain relievers may facilitate symptoms.


Corticosteroids, similar to prednisone, could facilitate shortening the time and intensity of joint and abdominal pain. as a result of these medicines will have serious side effects, discuss the risks and advantages of mistreating them together with your doctor.


If a section of the bowel has folded in on itself or ruptured, surgery may be needed.

Lifestyle and home remedies

Home care focuses on keeping individuals with gentle Henoch-Schonlein blood disease snug whereas the disease runs its course. Rest, many fluids and over-the-counter pain relievers could help.

Preparing for your appointment

You'll doubtless initially see your general practitioner or your child' podiatrist for this condition. you'll later be noted as an excretory organ specialist (nephrologist) if kidney complications develop. Here' some info which will assist you prepare for your appointment.

What you can do

Before your appointment, write answers to the following questions:

  • When did the symptoms begin?

  • Did they come on suddenly or gradually?

  • Was the person with the rash (you or your child) sick before the rash started?

  • What medications and supplements does the person with the rash take regularly?

Questions you may want to ask your doctor include:

  • What might be causing these symptoms?

  • What tests are needed to confirm the diagnosis?

  • Is this condition temporary or chronic?

  • How will I know if there's kidney damage? What if it turns up later?

  • How is Henoch-Schonlein purpura treated?

  • What are the side effects of treatment?

  • Do you have any literature on this condition? Can you recommend a website where I can learn more?

What to expect from your doctor

Your doctor is likely to ask a number of questions, such as:

  • What did the rash look like when it first started?

  • Is the rash painful? Does it itch?

  • Does the person with the rash have other symptoms, such as stomach pain or joint aches?

General summary

  1. Overall HSV patients live normal healthy lives with few restrictions However they are at risk for infections and should follow certain precautions to avoid getting sick For example they should avoid contact sports because the bruises that may result from a fall or collision can become infected HSV patients also should abstain from sharing personal items such as razors and towels because the virus can be spread by skin-to-skin contact.

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