Henoch-Schoenlein Purpura (3) Flashcards
What is this?
What occurs here?
➊ IgA vasculitis that presents with a purpuric rash on the lower limbs and buttocks in children
➋ Inflammation occurs in affected organs due to IgA deposits in blood vessels – Organs affected includes the Skin, Kidneys and GI tract
How does it present?
• Often preceded by an URTI or Gastroenteritis
• Purpura (100%) – In lower limbs and buttocks
• Arthralgia (75%) – In knees and ankles
• Abdominal pain (50%) – Severe cases can lead to haemorrhage, intussusception or bowel infarction
• IgA Nephritis (50%) – Haematuria +/- Proteinuria
‣ If 2+ protein on urine dip, pt has developed Nephrotic syndrome, and will have some degree of oedema
Which investigations are done?
What is its diagnostic criteria?
➊ • Exclude other serious pathologies, like meningococcal septicaemia and leukaemia
• Bloods – FBC, CRP, U&E, Albumin
• Blood film and culture
• Urine dip
• BP – for HTN due to renal involvement
➋ Pt has to have Purpura + at least 1 of:
• Arthralgia or Arthritis
• Diffuse abdominal pain
• Haematuria or Proteinuria
• IgA deposits on histology
How is it managed?
What’s the prognosis like for most pts?
What is the long-term prognosis mainly related to?
➊ • Supportive with simple analgesia, rest and hydration
• NSAIDs for analgesic and anti-inflammatory effects
• Close monitoring during active illness with Urine dips and BP to check for renal impairment
➋ Self-limiting with most recovering completely, but 1/3 having a recurrence of symptoms
➌ The extent of renal involvement – Those with nephrotic syndrome, renal impairment and HTN at presentation are likely to have a poorer outcome
