Health A-Z

Henoch-Schönlein purpura (HSP) is a type of vasculitis, or inflammation of blood vessels, that primarily affects small blood vessels in the skin, joints, intestines, and kidneys. Here's an overview of its symptoms, treatment plan, diagnosis, and testing.

1. Purpura: Characteristic red or purple spots on the skin caused by bleeding underneath the skin. These spots typically appear on the buttocks, legs, and elbows and may be associated with joint pain or swelling.
2. Joint pain: Arthritis-like symptoms, such as pain, swelling, and stiffness in the joints, particularly in the knees and ankles.
3. Abdominal pain: Often colicky or crampy in nature, abdominal pain may be accompanied by nausea, vomiting, and gastrointestinal bleeding.
4. Kidney involvement: Hematuria (blood in the urine), proteinuria (protein in the urine), or nephrotic syndrome (characterized by proteinuria, hypoalbuminemia, and edema) may occur, indicating kidney inflammation.
5. Other symptoms: Fever, malaise, and fatigue are common, especially during acute flare-ups of the condition.

1. Supportive care: Treatment focuses on relieving symptoms and preventing complications. Supportive measures may include:
   • Rest and hydration: Adequate rest and hydration help the body recover from acute symptoms.
   • Pain management: Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or acetaminophen may help relieve joint pain and fever.
   • Skin care: Keeping the skin clean and protected can prevent infection of purpura lesions.
2. Corticosteroids: In severe cases or when organ involvement is significant, corticosteroids such as prednisone may be prescribed to suppress inflammation and reduce symptoms.
3. Immunosuppressive therapy: In refractory cases or when corticosteroids are not effective, immunosuppressive medications such as azathioprine or cyclophosphamide may be used to control inflammation.
4. Treatment of complications: Management of complications such as gastrointestinal bleeding, kidney involvement, or severe abdominal pain may require additional interventions, including blood transfusions, intravenous fluids, or dialysis in cases of kidney failure.

1. Clinical evaluation: A healthcare provider will conduct a thorough medical history and physical examination to assess for characteristic symptoms of HSP, including purpura, joint pain, abdominal pain, and kidney involvement.
2. Laboratory tests: Blood tests may be performed to assess for markers of inflammation (e.g., erythrocyte sedimentation rate, C-reactive protein), kidney function (e.g., serum creatinine, urine protein), and coagulation profile.
3. Skin biopsy: A biopsy of purpura lesions may be performed to confirm the diagnosis and assess for signs of vasculitis on histological examination.
4. Urinalysis: Analysis of urine for the presence of blood (hematuria) and protein (proteinuria) is essential for evaluating kidney involvement.
5. Imaging studies: In cases of severe abdominal pain or suspected gastrointestinal involvement, imaging studies such as abdominal ultrasound or computed tomography (CT) may be performed to assess for gastrointestinal inflammation or bleeding.