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A.D.A.M. Medical Encyclopedia. Atlanta (GA): A.D.A.M.; 2011.

A.D.A.M. Medical Encyclopedia.

Henoch-Schonlein purpura

Anaphylactoid purpura; Vascular purpura

Last reviewed: June 20, 2011.

Henoch-Schonlein purpura is a disease that involves purple spots on the skin, joint pain, gastrointestinal problems, and glomerulonephritis (a type of kidney disorder).

Causes, incidence, and risk factors

Henoch-Schonlein is caused by an abnormal response of the immune system. It is unclear why this occurs.

The syndrome is usually seen in children, but it may affect people of any age. It is more common in boys than in girls. Many people with Henoch-Schonlein purpura had an upper respiratory illness in the weeks before.

Symptoms

Signs and tests

The doctor will examine your body and look at your skin. The physical exam will reveal skin sores (lesions) and joint tenderness.

Tests may include:

Treatment

There is no specific treatment. Most cases go away on their own without treatment. If symptoms persist, your doctor may recommend therapy with corticosteroids such as prednisone.

Expectations (prognosis)

The disease usually gets better on its own without treatment.

Complications

  • Bleeding inside the body

  • Kidney problems (in rare cases)

Calling your health care provider

Call for an appointment with your health care provider if:

  • You develop symptoms of Henoch-Schonlein purpura, particularly if they last for more than a few days

  • You have low urine output after an episode of Henoch-Schonlein purpura

References

  1. Miller ML, Pachman LM. Vasculitis syndromes. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2007: chap 166.

Review Date: 6/20/2011.

Reviewed by: Neil J. Gonter, MD, Assistant Professor of Medicine, Columbia University, NY and private practice specializing in Rheumatology at Rheumatology Associates of North Jersey, Teaneck, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

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What works?

  • Interventions to prevent or treat serious kidney disease in patients with Henoch‐Schönlein Purpura Interventions to prevent or treat serious kidney disease in patients with Henoch‐Schönlein Purpura
    Henoch‐Schönlein Purpura (HSP) causes inflammation of small blood vessels in children and affects approximately 20/100,000 children annually. Symptoms and signs include a purpuric skin rash (which comprises small spots and larger bruises), abdominal pain, gastrointestinal bleeding, joint pain and swelling, facial swelling and evidence of kidney disease with blood and protein in the urine. Kidney disease occurs in about one third of children with HSP. In the majority this is mild (small amounts of blood in the urine only) and resolves completely but a few children have persistent kidney disease that can progress to kidney failure. Treatments with medications that suppress the immune system (prednisone) and treatments to prevent blood clotting (aspirin, heparin) have been administered to children at diagnosis to prevent serious kidney disease. Also treatments which suppress the immune system (prednisone, methylprednisolone, cyclophosphamide and cyclosporin) have been used in an attempt to treat serious kidney disease in HSP and prevent progression to kidney failure.
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Figures

  • Henoch-Schonlein purpura on the lower legs.
    Henoch-Schonlein purpura.
    Henoch-Schonlein purpura.
    Henoch-Schonlein purpura.
    Henoch-Schonlein purpura on an infant's foot.
    Henoch-Schonlein purpura on an infant's legs.
    Henoch-Schonlein purpura on an infant's legs.
    Henoch-Schonlein purpura on the legs.

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Drug of interest

  • Prednisone
    Prednisone is used alone or with other medications to treat the symptoms of low corticosteroid levels (lack of certain substances that are usually produced by the body and are needed for normal body functioning). Prednisone is also used to treat other conditions in patients with normal corticosteroid levels. These conditions include certain types of arthritis; severe allergic reactions; multiple sclerosis (a disease in which the nerves do not function properly); lupus (a disease in which the body attacks many of its own organs); and certain conditions that affect the lungs, skin, eyes, kidneys blood, thyroid, stomach, and intestines. Prednisone is also sometimes used to treat the symptoms of certain types of cancer. Prednisone is in a class of medications called corticosteroids. It works to treat patients with low levels of corticosteroids by replacing steroids that are normally produced naturally by the body. It works to treat other conditions by reducing swelling and redness and by changing the way the immune system works.

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