Henoch–Schönlein Purpura

Henoch–Schönlein Purpura

Henoch–Schönlein purpura is the combination of some of the following features:

• Characteristic skin rash on extensor surfaces
• Arthralgia
• Periarticular edema
• Abdominal pain: hematemesis, melena, intussusception
• Glomerulonephritis

It usually occurs between the ages of 3–10 years.

Twice as common in boys, peaks during the winter months, and is often preceded by an upper respiratory infection. Genetic predisposition and antigen exposure increase circulating IgA levels and disrupt IgG synthesis.

The IgA and IgG interact to produce complexes that activate complement and are deposited in affected organs, precipitating an inflammatory response with vasculitis.

Follow-Up for Henoch–Schönlein Purpura

All children with Henoch–Schönlein purpura should be followed for a year to detect those with persisting hematuria or proteinuria (5–10%).

Children who have persistent renal involvement or required treatment for Henoch–Schönlein purpura nephritis require long-term follow-up.

This is necessary as hypertension and progressive chronic kidney disease may develop after an interval of several years.