Henoch-Schönlein purpura (HEH-nok SHOON-line PURR-pyuh-ruh) is a condition
that makes small blood vessels get swollen and irritated. This inflammation is called
vasculitis. It usually happens in the skin, intestines, and kidneys.
Inflamed blood vessels in the skin can leak blood cells, causing a rash called
purpura. Vessels in the intestines and kidneys also can swell and
Henoch-Schönlein purpura (HSP) is also called allergic purpura, anaphylactoid
purpura, or IgA vasculitis.
Who Gets Henoch-Schönlein Purpura?
Henoch-Schönlein purpura happens much more often in kids than in adults, usually
between ages 3 and 10. It's one of the most common forms of vasculitis in children,
and boys get it about twice as often as girls.
Most children with HSP fully recover within a month and have no long-term problems.
Kids whose kidneys are affected will need to see a doctor for regular checkups to
monitor kidney function.
What Causes Henoch-Schönlein Purpura?
No one really knows what causes Henoch-Schönlein purpura. But doctors do know
that it happens when the body's immune
system doesn't work as it should. A protein called immunoglobulin A (IgA) is a
type of antibody that works to fight infections. In HSP, IgA also gets placed in the
blood vessels and causes swelling and bleeding.
This immune reaction often happens after a bacterial or viral infection of the
upper respiratory tract (sinuses, throat, or lungs). It is seen more often in fall,
winter, and spring. Other less common triggers include some medicines, reactions to
food, insect bites, and vaccinations.
HSP cannot be passed from one person to another.
What Are the Signs & Symptoms of Henoch-Schönlein Purpura?
Common signs and symptoms of Henoch-Schönlein purpura include:
The rash happens in all cases and is what helps doctors diagnose HSP. It can look
like pinpoint red dots (called petechiae [puh-TEEK-ee-ee]), bruises, or sometimes
blisters. The rash usually is on the legs and buttocks, but can be on other parts
of the body, such as the elbows, arms, face, and trunk.
Most kids with HSP also have joint pain and swelling. These symptoms can happen
before the rash appears. This often affects the ankles and knees, but can happen in
other joints like the hands, elbows, and feet.
Stomach pain usually starts a week after the rash. Pain may come and go and can
be accompanied by nausea, vomiting, or diarrhea. Some kids will have blood in the
stool (caused by leaky blood vessels), but it may not be visible.
HSP can affect the kidneys in some cases. Small amounts of blood or protein might
be found in the urine, and the urine may look bloody.
Symptoms of Henoch-Schönlein purpura usually last for about a month.
How Is Henoch-Schönlein Purpura Diagnosed?
Doctors can easily diagnose Henoch-Schönlein purpura if the rash is on
the legs and buttocks, especially if a child also has belly or joint pain. Diagnosis
might be harder if joint pain or belly problems start before the rash appears, or
if symptoms take several weeks to show up.
The doctor also may order blood tests to look for signs of infection, anemia,
disease. If belly pain is severe, imaging tests (like X-rays or an ultrasound)
may be needed. A stool test can
check for blood in the stool (poop). A urine sample can reveal blood or protein in
Up to half of kids who develop HSP will have problems with their kidneys. So the
doctor will probably check kidney function over several months. If the HSP might have
caused kidney damage, a child may need to see a kidney doctor (nephrologist).
How Is Henoch-Schönlein Purpura Treated?
Most of the time, Henoch-Schönlein purpura goes away on its own without
treatment. To help your child feel better, the doctor may recommend medicines such