Henoch-Schonlein purpura (HSP) is
inflammation of the blood vessels in the skin and other body organs. When it involves the skin, it causes a telltale rash. The rash looks like bruising or small dots in the skin, referred to as purpura.
HSP is caused by an abnormal reaction of the immune system. Normally, the immune system marks and attacks foreign items like viruses and bacteria. However, with HSP, the immune system attacks the blood vessels. It is not clear why the immune system attacks the body.
The change in the immune system may be triggered by: Bacterial or viral infectionsCertain medicationsRecent exposure to certain vaccinesInfection by insect bites
HSP occurs most often after a respiratory infection. HSP is not contagious.
HSP is most common in children aged 2 to 11 years old, but it can occur at any age.
Factors that increase your risk of HSP include:
Recent upper respiratory illness, such as a
coldRecent exposure to vaccines, chemicals, cold weather, or insect bites
Symptoms may last for 4 to 6 weeks and may include:
Reddish-purple spots that
can be felt and
are not itchyOften appears on the buttocks or legs, may appear on the elbows
Red spots of various sizes
Bruising, usually below the waistPain in the joints, especially knees and anklesAbdominal painBlood in the urine caused by kidney inflammationSwelling of the anklesSwelling of the scrotum in malesFeverBlood in the stoolVomiting
Your doctor will ask about your symptoms and medical history. A physical exam will be done.
Your bodily fluids, tissues, and waste may be tested. This can be done with: Blood testsUrinalysisStool sampleSkin biopsy
from an area of the rash
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HSP usually gets better on its own. Your doctor may prescribe medications if symptoms or complications are causing problems. Medications may include:
Nonsteroidal anti-inflammatory drugs (NSAIDs)—to lessen joint pain and
arthritisSteroid medication—for significant abdominal pain, joint pain, or kidney diseaseAntibiotics—to treat bacterial infection
Cyclophosphamide (Cytoxan)—to suppress the immune system when you have symptoms of severe kidney disease
There are no guidelines to prevent HSP. Relapse occurs in about 50% of cases.
It is important to make sure that you have long-term, follow-up visits with your doctor to be sure that kidney disease doesn't develop.
Dillon MJ. Henoch-Schonlein purpura (treatment and outcome).
Cleve Clin J Med. 2002;69(Suppl 2):SII121-SII123.
Ronkainen J, Koskimies O, et al. Early prednisone therapy in Henoch-Schonlein purpura: a randomized, double-blind, placebo-controlled trial.
J Pediatr. 2006;149:241-247.
Saulsbury FT. Epidemiology of Henoch-Schonlein purpura.
Cleve Clin J Med. 2002;69(Suppl 2):SII87-SII89.
Last reviewed August 2013 by Michael Woods, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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