Henoch-Schönlein Purpura – Causes, Symptoms & Treatment

Written by Rakhee M • 

Do you notice a purple rash on your child’s body? Is the outbreak of the rash accompanied by other conditions like stomach ache and diarrhea? If you nodded along in agreement, your little one might be suffering from Henoch-Schönlein purpura or HSP. But, what is Henoch-Schönlein purpura or HSP in children and how does it affect them? Read our post below and find out here.

What Is HSP Or Henoch-Schonlein Purpura In Children?

Henoch-Schönlein purpura (HSP) is an extremely rare circulatory system disorder that causes swelling of the blood vessels. The swelling, or vasculitis, triggers leaks in the blood vessels. The condition mostly affects blood vessels present in the kidneys, joints, intestines and the skin. The blood leak causes a rash on the body, or the purpura [1].

HSP can affect people of all age groups. But the disease is most commonly seen in children between the ages of two and six years. For some reason, HSP affects more boys than girls. Usually, the rash disappears without needing any treatment. But, treatment of Henoch Schonlein Purpura in children may be necessary, or indeed important if the condition triggers severe kidney damage or any other health complications [2].

[ Read: Joint Pain In Children]

Causes Of Henoch-Schönlein Purpura:

HSP is an autoimmune disease. So, when the body is under attack from an infection, the immune system creates antibodies to fight the germs. Autoimmune disorders typically make the immune system attack an organ or cells and lead to reactions [3].

  • In the case of HSP, the target of the antibodies becomes the blood vessels. It is not yet known what causes the immune system to attack the blood vessels.
  • But most people suffer from HSP after a cold or any infection in the upper respiratory track.
  • Other infections that may cause HSP are measles, strep throat, hepatitis and chicken pox.
  • Certain external conditions such as food, medicines, cold weather exposure or insect bites may also trigger HSP.
  • The cause can also be genetic [4].

Symptoms Of Henoch-Schönlein Purpura:

There are many symptoms of HSP.

1. Rash (Purpura):

The most distinguishing symptom of HSP is the rash. It appears as red or purple spots on legs, feet, thighs and the buttocks. But in adults and older children, it can also spread to arms, face and the torso.

2. Digestive Disorders:

HSP in kids can cause gastrointestinal symptoms such as abdominal pain, vomiting, and nausea. Blood in the stool is also possible. These symptoms may also manifest before the appearance of the rash.

[ Read: Skin Rashes In Children ]

3. Kidney Involvement:

If HSP affects your kidneys, you may notice blood in your urine (hematuria). The presence of excessive proteins in your urine (proteinuria) may suggest a severe problem. In some cases, kidney problems may persist even after the HSP symptoms have cleared up.

4. Arthritis:

Pain and inflammation in joints (ankles, knees) can occur a few days before the appearance of the rash. The pain can also spread to elbow joints.

5. Others:

In rare cases, people with HSP can suffer from seizures or pneumonia. Swelling in the testicles and painful menstruation are other less common symptoms of HSP [5].

Diagnosing Henoch-Schönlein Purpura:

Your doctor may diagnose HSP in children based on the rashes on your skin, especially if it occurs with any gastrointestinal problem or joint pain. But to confirm the diagnosis, some tests may be necessary [6].

1. Blood Tests:

If you have HSP, you may have a specific type of antibody present in your blood in abnormally large quantities. A blood test may help your doctor to confirm the HSP diagnosis even when the classic symptoms of gastrointestinal troubles or arthritis are not present.

2. Urinalysis:

The doctor may conduct a urinalysis to detect blood or protein in your urine sample. This test can also help your doctor identify any kidney problems that may be present due to your HSP.

3. Skin Biopsy:

A biopsy can confirm the presence of antibodies on the skin. Your doctor will take your skin tissue sample and study it using a microscope. This test may require the use of local anesthesia.

4. Kidney Biopsy:

In case, your HSP symptoms are serious or if your doctor suspects severe kidney involvement, he may order a kidney biopsy. This test may also help your doctor to prescribe a proper treatment to protect your kidney from any potential damage from HSP.

5. Imaging Tests:

If needed, your doctor may order an ultrasound to rule out other possible reasons for your gastrointestinal problems.

[ Read: Ibuprofen For Kids ]

Treating Henoch-Schönlein Purpura:

There is no specific treatment available for Henoch-Schonlein Purpura in children. The condition improves within a few weeks. But you may require treatment to find relief from specific symptoms such as kidney or gastrointestinal problems. Your child can have lasting kidney damage if he doesn’t receive treatment for HSP on time.

  • Your doctor may prescribe you ibuprofen or aspirin for relief from joint pains.
  • Some doctors may also prescribe prednisone, which is a powerful corticosteroid and is used to treat severe symptoms of the gastrointestinal track. Corticosteroids also reduce inflammation and affect the immune system. But these also produce serious side effects such as glaucoma, high blood pressure, fluid retention in legs, mood swings, weight gain and others. These are prescription-based drugs. But even so, always discuss their usefulness versus side effects with your doctor before you decide to take them.
  • For severe kidney problems, your doctor may prescribe corticosteroids or other immunosuppressive medicines like Cytoxan. Immunosuppressive drugs hinder the immune system from making antibodies.
  • For serious complications in the gastrointestinal tract such as bowel ruptures, surgery may be necessary.
  • If HSP affects your blood pressure, your doctor may prescribe medicines to regulate it. Some medicines for blood pressure like angiotensin receptor blockers (ARBs) help dilate the blood vessels. ARBs may also help with kidney problems as present in HSP.

There is not much you can do regarding diet to prevent HSP disease in kids. Usually, the condition is not a cause of worry. Often, your child with HSP can continue his normal routine without any problems. But you need to observe any symptoms that might worsen and require immediate attention. Your child may need plenty of rest and fluids along with any other treatment.

If you see HSP rash on your child’s body, consult a doctor for the proper care and a treatment plan.

Was your child ever diagnosed with HSP? Did he suffer from any severe complications? Please share some care tips for our readers.

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