Henoch-Schoenlein Purpura

What is Henoch-Schoenlein purpura?

Henoch-Schoenlein purpura (HSP) is a disease that causes bleeding from small, inflamed blood vessels into the skin. The bleeding causes a red or purple rash called purpura.

What is the cause?

Inflammation (swelling) in the blood vessels causes the symptoms. Doctors don’t know what causes the swelling. It may be a response to infection. The illness is often seen in children who had a cold a few weeks earlier. The antibodies made by the body to fight the cold may keep attacking other cells in the body. Other theories are that medicines, insect bites, cold temperatures, chemicals, or some foods are related to the cause. No one knows for certain.

HSP is not an inherited disease, and it is not contagious.

What are the symptoms?

HSP can affect other parts of the body as well as the skin. Symptoms may include:

• Rash: The rash is often on the buttocks and legs. The rash may first look like hives, but usually it changes to purplish or brownish bruises within 1 to 2 days. There is almost always some rash on the ankles.
• Painful swelling of the joints: The joints that are most often painful are the knees and ankles. The pain may be bad enough to make your child unable or unwilling to walk.
• Stomach pain or blood in the bowel movements
• Fever
• Blood in the urine

How is it diagnosed?

Your healthcare provider will examine your child. Your child may have one or more tests, such as:

• blood tests
• urine tests
• tests of a sample of bowel movement

How is it treated?

There is no medicine that will cure this illness. There is no way to predict who will get HSP and no way to prevent it. In most cases, HSP lasts 4 to 6 weeks, and doesn’t cause any lasting problems. Symptoms may come and go during this time. The older your child is, the more likely it is that he or she will have the symptoms again. Your child will eventually get better on his or her own.

Your child's healthcare provider may prescribe a steroid medicine, such as prednisone, to reduce inflammation in the intestine. The steroid may help control pain and bleeding in the bowel.

Most children recover from HSP completely and have no further problems. In rare cases, it may affect the kidneys. Your child will need to see your healthcare provider for blood pressure checks and urine tests every 1 to 2 months over the next 2 years to check the kidneys.

How can I take care of my child?

You can help relieve your child's symptoms with:

• Pain medicine. The best and safest medicine to help with the pain and inflammation of swollen joints is ibuprofen. Use the same dose you use when your child has a fever. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, may cause stomach bleeding and other problems. These risks increase with age. Read the label and give as directed. Unless recommended by your healthcare provider, your child should not take this medicine for more than 10 days for any reason.

  Acetaminophen may help with the pain, but it will not relieve swelling and inflammation.

• Fluids. Encourage your child to drink plenty of fluids and to eat a normal diet.

Ask your healthcare provider:

• how and when you will hear your child’s test results
• how long it will take your child to recover from this illness
• what activities your child should avoid and when your child can return to normal activities
• how to take care of your child at home
• what symptoms or problems you should watch for and what to do if your child has them

Make sure you know when you should bring your child back for a checkup.