Henoch-Schonlein Purpura

Question 1

What is HSP?

Answer 1

HSP is a small vessel vasculitis.

Question 2

What characterises HSP?

Answer 2

1. Purpuric Rash
2. Abdominal Pain
3. Joint Pain
4. Glomerulonephritis

Question 3

What causes HSP?

Answer 3

HSP normally follows an infection, typically an upper respiratory tract infection.

It is immune-mediated, but the exact cause remains unclear.

IgA-containing immune complexes are deposited in affected tissues.

Question 4

How does HSP present?

Answer 4

Typically HSP presents with palpable purpura, with preponderance for dependent areas, e.g. buttocks, lower limbs, arthralgia, or abdominal pain.

Less commonly, HSP may present with scrotal pain/swelling, and rarely with pulmonary haemorrhage.

Question 5

How is HSP investigated?

Answer 5

Urinalysis

Bloods

FBC, CRP, U+E, Clotting, Cultures

Think about other causes of non-blanching rashes, e.g. clotting disorders, meningococcal sepsis.

US Abdomen

Think about intussusception and other causes of abdominal pain.

Question 6

How is HSP managed?

Question 7

What are the complications of HSP?

Answer 7

Complications include:

• Bowel infarction
• Gastrointestinal haemorrhage
• Hypertension
• Intussusception
• Myocardical infarction
• Nephritis
• Nephrotic syndrome
• Renal failure
• Neuropathy
• Seizure
• Death