Henoch-Schönlein purpura

Last Updated on by FRCEM Intermediate

Overview

  • IgA-mediated – autoimmune hypersensitivity vasculitis
  • children aged 4 – 6 years

Clinical Features

  • preceding upper respiratory tract infection (URTI)
  • reddish-purple purpura on the backs of the legs, buttocks, trunk, and back
  • Associated symptoms include abdominal pain,testicular pain, and joint pains
  • Nephritis may occur, producing micro- or macroscopic haematuria, proteinuria. Very occasionally, this progresses to renal failure

Investigations

  • Check BP,
  • urinalysis, urine microscopy,
  • FBC (platelets are normal),
  • U&E.

Management

  • Refer to the pediatrician.

Complications

  • HSP progress to end-stage kidney disease
  • myocardial infarction,
  • pulmonary haemorrhage,
  • pleural effusion,
  • intussusception (in 2-3% of patients),
  • gastrointestinal bleeding,
  • bowel infarction,
  • seizures
  • mononeuropathies.

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