What is Henoch-Schönlein Purpura (HSP)?
Henoch-Schönlein Purpura (HSP) is a form of small vessel vasculitis that primarily affects children. It is characterized by a distinctive purplish rash, arthritis, abdominal pain, and kidney involvement. HSP is the most common vasculitis in children and usually presents in those between the ages of 3 and 15.
What causes HSP?
The exact cause of HSP remains unknown, but it is often preceded by an upper respiratory infection. Other potential triggers include certain medications, vaccinations, and food allergies. It is generally believed that an abnormal immune response plays a significant role in the development of this condition.
What are the symptoms?
The hallmark symptom of HSP is a palpable purpuric rash that typically appears on the lower extremities and buttocks. Other common symptoms include:
Joint pain and swelling, particularly in the knees and ankles
Abdominal pain and gastrointestinal bleeding
Kidney involvement, which may present as hematuria or proteinuria
How is HSP diagnosed?
Diagnosis is primarily clinical, based on the characteristic rash and associated symptoms. Laboratory tests may be used to support the diagnosis and rule out other conditions. These tests include:
Complete blood count (CBC)
Urinalysis
Blood urea nitrogen (BUN) and creatinine levels
Stool guaiac test
In some cases, a skin or kidney biopsy may be necessary to confirm the diagnosis.
What is the treatment?
HSP is usually a self-limiting condition that resolves on its own within a few weeks to months. Treatment is primarily supportive and focuses on symptom management. This may include:
Pain relief with acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs)
Hydration and rest
Corticosteroids for severe abdominal pain or kidney involvement
What are the potential complications?
While most children recover fully from HSP, complications can occur, particularly involving the kidneys. Some children may develop chronic kidney disease, necessitating long-term follow-up and management. Rarely, intussusception, a type of bowel obstruction, may occur and require surgical intervention.
How can HSP be prevented?
There is no known way to prevent HSP, given its unclear etiology. However, managing underlying infections and reducing exposure to potential triggers may help mitigate the risk.
Severe abdominal pain
Blood in the urine or stool
Swelling in the face or legs
Severe joint pain that limits movement
Conclusion
Henoch-Schönlein Purpura is a common pediatric vasculitis with a generally favorable prognosis. Early recognition and appropriate management are crucial to minimize complications and ensure a full recovery. Parents and caregivers should be aware of the symptoms and seek medical attention promptly if necessary.
