Henoch-Schonlein Purpura

Question 1

What is HSP?

Answer 1

A systemic, small-vessel, IgA immune complex mediated leukocytoclastic vasculitis

Question 2

What is HSP characterized by in regards to tetrad?

Answer 2

Palpable Purpura
Abdominal Pain
Renal Disease Arthritis/Arthralgias

Question 3

What is the epidemiology of HSP

Answer 3

Most common vasculitis seen in children and younger age groups

M:F - 2:1

90% of all pts are

Question 4

What is the etiology of HSP?

Answer 4

Exposure to a trigger antigen that causes antibody formation

Question 5

Where does antigen-antibody (immune) complex deposition occur?

Answer 5

In arteriole and capillary waslls of

• Skin
• Renal Mesangium
• GI tract

IgA is most common

Question 6

What are the possible triggers in patients with HSP?

Answer 6

• Group A streptococci infection
• URI and other viral illnesses
• Drugs

Question 7

Where does the palpable purpura result in patients with HSP?

Answer 7

Dependent areas, especially BLEs

Areas subjected to pressure, such as beltline in adults or buttocks in toddlers

Question 8

What is important concerning arthralgias and arthritis in patient with HSP?

Answer 8

60-85%

Typically oligoarticular, affecting LE and large jts.

Question 9

What is important concerning abdominal pain in patient with HSP?

Answer 9

N/V
Diarrhea
Cramping
Hematochezia
Melena

Question 10

What is important concerning renal involvement in patient with HSP?

Answer 10

Up to 80% of older children, usually within 1st month of illness

Question 11

What is the clinical presentation of HSP?

Answer 11

Palpable Purpura
Arthralgias and arthritis 
Oligoarticular
GI Symptoms
Abdominal Pain
Renal Involvement
Subcutaneous Edema

Question 12

What is the diagnosis of HSP dependent on?

Answer 12

Finding IgA in the affected vessels

Palpable purpura unrelated to thrombocytopenia

Question 13

What is the ACUTE treatment of HSP?

Answer 13

Prednisone 1-2 mg/kg po daily for 2 weeks