Henoch-Schonlein Purpura Flashcards
What is Henoch-Schonlein Purpura (HSP)?
It is defined as an IgA mediated small vessel vasculitis, in which there is deposition of IgA is deposited in vessel walls – leading to inflammation
Which three regions of the body tend to be affected by Henoch-Schonlein purpura?
Skin
Kidneys
Gastrointestinal Tract
What four risk factors are assoicated with Henoch-Schonlein purpura?
Children, 4 – 6 Years Old
Male Gender
Upper Respiratory Tract Infection
Gastroenteritis
What are the eight clinical features of Henoch-Schonlein purpura?
Prodromal Coryzal Features
Low Grade Fever
Purpuric/Petechial Rash
Peripheral Oedema
Abdominal Pain
Polyarthritis
Frothy Urine
Haematuria
Why is a rash associated with Henoch-Schonlein purpura?
It is due to inflammation and leaking of blood from small blood vessels under the skin
Describe the rash associated with Henoch-Schonlein purpura
It is present on the buttocks and extensor surfaces of arms/legs
What are petechiae?
It is defined as a non-blanching pinot spots < 3mm in diameter
What are purpura?
It is defined as a non-blanching pinot spots > 3mm in diameter, commonly palpable
Describe the arthralgia assoicated with Henoch-Schonlein purpura
It tends to present with pain the hip, knee and ankle joints
What three investigations are used to diagnose Henoch-Schonlein purpura?
Blood Tests
Urinalysis
Renal Biopsy
How are blood tests used to investigate Henoch-Schonlein purpura?
They are used to exclude differential diagnoses, and assess for organ involvement
What eight blood tests are used to investigate Henoch-Schonlein purpura?
Full Blood Count
Liver Function Tests
Urea & Electrolytes
Serum Albumin
Serum CRP
Clotting Studies
Blood Film
Blood Cultures
How is urinalysis used to investigate Henoch-Schonlein purpura?
It is used to exclude differential diagnoses, and assess for renal involvement
What are the three features of Henoch-Schonlein purpura on urinalysis?
Haematuria
Proteinuria
Increased Protein : Creatinine
When are renal biopsies used to investigate Henoch-Schonlein purpura?
When there is ongoing significant proteinuria or impaired renal function
What is the feature of Henoch-Schonlein purpura on renal biopsies?
The presence of the IgA deposits within blood vessel walls
What is the diagnostic criteria of Henoch-Schonlein purpura?
A diagnosis is obtained when individuals present with palpable purpura and one of the following criteria…
- Diffuse Abdominal Pain
- Polyarthralgia
- Proteinuria/Haematuria
- Positive Histopathology
What is the first line management option of Henoch-Schonlein purpura?
Conservative Management
What is the conservative management option of Henoch-Schonlein purpura?
It involves supportive management with rest, simple analgesia and hydration
In addition, we advise individuals that it is a self-limiting condition which usually resolves within a period of weeks to months
What is the pharmacological management option of Henoch-Schonlein purpura?
Corticosteroids
When are corticosteroids used to manage Henoch-Schonlein purpura?
When there is severe gastrointestinal pain or renal impairment
How are corticosteroids used to manage Henoch-Schonlein purpura?
It is used to shorten the duration of illness; however, it is important to note that it doesn’t affect long term outcomes or recurrence rates
Why are follow up appointments important in Henoch-Schonlein purpura?
This is due to the fact that renal involvement may not manifest until weeks later
What follow up review is requried to manage Henoch-Schonlein purpura?
We conduct urine dipstick and blood pressure readings regularly for a period of six months after diagnosis
In cases where children present with renal involvement features, they must be re-reviewed in secondary care
However, children can be fully discharged if they have two consecutive normal urine dips and a normal blood pressure at six months
What are the two complications associated with Henoch-Schonlein purpura?
Henoch-Schonlein Purpura Relapse
Renal Failure
