Overview

• Henoch-Schonlein Purpura (HSP) → IgA mediated small vessel vasculitis. Usually seen in children (3-5 yo) following infection.
  • Inflammation occurs in affected organs due to IgA deposits in blood vessels.
  • Typically affects the skin, kidneys and GI tract.
  • Often triggered by an upper airway infection or gastroenteritis.

Making Diagnosis

Clinical Features

• Palpable purpuric rash on legs, arms, buttocks, ankles (100%) + Joint pain (60-80%) + Abdominal pain (60%).

• Renal involvement (in 50%) → IgA nephritis. Can cause haematuria, proteinuria and oedema.

  <aside> 💡 ITP = no proteinuria

  </aside>

Investigations

• Exclude other pathologies that may cause rash → meninigicoccal septicaemia, leukaemia, ITP, HUS.
• Follow-Up (for 6-12 months) → monitor blood pressure and urinalysis to detect progressive renal involvement.
  • Urinalysis Abnormality → spot urine sample to quantify proteinuria (ACR or PCR).

Management Plan

• Most cases will resolve spontaneously within 4 weeks.
• Supportive → analgesia, rest and proper hydration.

Complications →

Prognosis → usually self-limiting, especially in those without renal involvement. 1/3 of patients have recurrence within 6 months.