Key points to remember about HSP (Henoch-Schonlein purpura)

HSP is a disease which causes inflammation (irritation and swelling) of the small blood vessels in the skin resulting in a rash or purple spots (purpura)
HSP can also affect blood vessels around the kidneys and intestines
HSP can cause joint pain
HSP occurs most often in children from two to ten years of age
the cause of HSP is unknown
pain relief (such as paracetamol) can help the joint pain. You must follow the dosage instructions on the bottle. It is dangerous to give more than the recommended dose
return to your doctor if there is increasing pain, swelling, blood in your child’s poo (stools, faeces) or wee (urine) or if you are worried at all
long-term follow-up for urine and blood pressure checks is very important to detect kidney disease

What is HSP (Henoch-Schonlein purpura)?

HSP is a disease that causes:

purple spots (purpura) on the skin

It can also cause:

joint pain
gastrointestinal problems (problems of the digestive tract, which includes the mouth, oesophagus, stomach, and intestines)

HSP is also known as anaphylactoid purpura or vascular purpura. Also, Schonlein is sometimes spelt Schoenlein.

What causes HSP (Henoch-Schonlein purpura)?

HSP results from blood vessels becoming inflamed (irritated and swollen). This inflammation is called vasculitis. The vasculitis affects the small blood vessels in the skin, causing a rash that is called purpura. It can also affect blood vessels around the joints, in the intestines and in the kidneys.

The cause of HSP is unknown. It might be triggered by bacterial or viral infections, medicines, insect bites or exposure to chemicals or cold weather. It occurs most often in the spring, usually after an upper respiratory infection, like a cold.

HSP usually affects children from two to ten years of age, but it can happen in anyone. HSP itself is not contagious (catching). Doctors don't know how to prevent HSP yet.

What are the signs and symptoms of HSP (Henoch-Schonlein purpura)?

skin rash: this may start out looking like red spots,bumps or raised red skin welts which can be itchy. This quickly changes to small bruises or reddish-purple spots that are often raised; it usually appears on the buttocks, on the legs and around the elbows. Blisters and / or ulcers may develop in the affected areas
swelling: many children with HSP also have swelling over the backs of their feet and hands, and the scrotum in boys
pain and swelling in the joints (such as the knees and ankles) which is often intermittent (comes and goes) and can move around from joint to joint
stomach pain, which can be intermittent and in some cases can be severe
blood in the poo (stools, faeces) or wee (urine): this is caused by the blood vessels in the bowel and the kidneys becoming inflamed (irritated and swollen); serious kidney problems don't happen very often, but they can occur

See Acknowledgements for the above images.

How is HSP (Henoch-Schonlein purpura) diagnosed?

There is no specific laboratory test for the disease. The diagnosis of HSP is made by evaluating the signs and symptoms. Your doctor will usually order blood tests to exclude other conditions. If the diagnosis is suspected, your child will have urine tests to look for possible kidney involvement.

What is the treatment for HSP (Henoch-Schonlein purpura)?

Fortunately, HSP usually gets better without any treatment. Pain relief (such as paracetamol) can help the joint pain. You must follow the dosage instructions on the bottle. It is dangerous to give more than the recommended dose.

Your doctor may recommend a drug called prednisolone. This can help people with severe stomach pains or very painful joints.

How long does HSP (Henoch-Schonlein purpura) last?

The illness lasts four to six weeks in most patients. The rash (purpura) changes from red to purple, becomes rust-coloured and then fades completely.

About half of the patients who have had HSP once will get it again.

What are the complications of HSP (Henoch-Schonlein purpura)?

For most people HSP is a self-limiting condition with no long-term problems. About five percent of those with HSP develop long-term kidney disease (glomerulonephritis)¹. This may occur in the first week or so of illness, but there may be a delay of weeks or months before it appears. Your doctor will want to check urine samples and blood pressure several times after the HSP goes away to check for kidney problems. These checks should go on for at least six months and some doctors recommend a blood pressure and urine check every year for life.

When should I seek help for HSP (Henoch-Schonlein purpura)?

Return to your doctor or the hospital if your child has one or more of the following or if you are worried for any other reason:

increasing stomach pains
swelling and pain that is not responding to painkillers
blood in the poo (stools, faeces) or wee (urine)

Where to go for more information about HSP (Henoch-Schonlein purpura)

DermNet NZ
The website of the New Zealand Dermatological Society has a fact sheet on Henoch-Schonlein purpura² and a wide range of other information on skin conditions.
Website: http://www.dermnet.org.nz/

Acknowledgements

This fact sheet has been adapted from:

The Royal Children’s Hospital (Melbourne) Kids Health Info for parents: Henoch-Schonlein purpura (HSP)

Images of HSP (Henoch-Schonlein purpura) on this page have been reproduced, with permission, from the website of the New Zealand Dermatological Society Incorporated. Published online at: http://www.dermnetnz.org.

Links (these are the web addresses for the numbered links in the text above)

[1] http://www.nlm.nih.gov/medlineplus/ency/article/000484.htm

[2] http://www.dermnet.org.nz/vascular/hsp.html

Your notes

Endorsement

This fact sheet was endorsed by PSNZ - 13/09/2007

Copyright

Fact sheets are subject to copyright. In the interests of information sharing they may be copied but acknowledgement must be given to PSNZ and Starship Foundation.
© The Paediatric Society of New Zealand and Starship Foundation 2005 - 2012

The Paediatric Society of New Zealand
http://www.paediatrics.org.nz

Starship Foundation
http://www.starship.org.nz

The Paediatric Society of New Zealand
http://www.paediatrics.org.nz

Starship Foundation
http://www.starship.org.nz

This fact sheet was printed on: 10-Feb-2012 03:52am