Pediatric Henoch-Schonlein Purpura

Henoch-Schönlein purpura (HSP) is a condition that involves swelling (inflammation) of small blood vessels. The swollen blood vessels leak into the skin, joints, intestines and kidneys. HSP is seen most often in children between ages two and six. It occurs more often in boys. The disease can happen in siblings of the same family. Most children with HSP recover fully. But some children may have kidney problems.

HSP is an autoimmune disorder. This is when the body’s immune system attacks the body’s own cells and organs. With HSP, this immune response may be caused by an upper respiratory tract infection. Other immune triggers may include an allergic reaction, medicine, injury or being out in cold weather.

Each child’s symptoms can vary. Common symptoms include:

• A rash caused by blood leaking into the skin
• Blood leaking into mucous membranes, internal organs and other tissues
• Joint pain and swelling (arthritis)
• Belly (abdominal) pain
• Bleeding in the digestive tract, which includes the mouth, esophagus, stomach and intestines
• Swollen kidneys
• Swelling just below the skin
• A brain disorder
• Inflammation of the testicles

These symptoms can seem like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

Your child’s healthcare provider will ask about your child’s health history and do a physical exam. Diagnosis is based on symptoms such as:

• Joint pain and swelling (arthritis)
• A rash
• Belly pain
• Kidney disease

Your child may also need tests, such as:

• Biopsy. Small tissue samples may be taken. They may be taken from the skin or the kidney. They are looked at with a microscope. This may only be needed if the diagnosis is unclear.
• Blood and urine tests. Your child's urine will be checked for blood and protein. A blood test can check kidney function.
• Ultrasound. This imaging test uses sound waves and a computer to make pictures of blood vessels, tissues and organs. It may be used to look at the digestive tract for signs of the disease.

Treatment will depend on your child’s symptoms, age and general health. It will also depend on how severe the condition is.

Treatments for HSP may include:

• Making sure your child drinks enough fluids
• Making sure your child eats a healthy diet
• Taking medicines such as acetaminophen to help ease pain
• Taking glucocorticoids to control inflammation
• Taking blood pressure medicine to lower blood pressure if needed
• Natural supplements such as fish oil and antioxidants may help

Talk with your child’s healthcare provider about the risks, benefits and possible side effects of all medicines.

Most children with HSP recover fully. But some children may have kidney damage. In rare cases, a child may have kidney failure. Women who have had HSP as a child have a higher risk for pregnancy-induced hypertension (pre-eclampsia).

Tell the healthcare provider if your child’s symptoms get worse or there are new symptoms.