Henoch-Schonlein purpura

Henoch-Schonlein purpura (HEN-awk SHURN-line PUR-pu-ruh) is a disorder that causes

inflammation and bleeding in the small blood vessels in your skin, joints, intestines and kidneys.
The most striking feature of Henoch-Schonlein purura is a purplish rash, typically on the lower
legs and buttocks. Henoch-Schonlein purpura can also cause abdominal pain and aching joints.
Rarely serious kidney damage can occur.
Although Henoch-Schonlein purpura can affect anyone, it's most common in children between
the ages of 2 and 6. Henoch-Schonlein purpura usually improves on its own. Medical care is
generally needed if the disorder affects the kidneys
Symptoms
There are four main characteristics of Henoch-Schonlein purpura, although not everyone with
the disease develops all four. They include:

Rash (purpura). Reddish-purple spots, which look like bruises, are the most distinctive
and universal sign of Henoch-Schonlein purpura. The rash develops mainly on the
buttocks, legs and feet, but it can also appear on the arms, face and trunk and may be
worse in areas of pressure, such as the sock line and waistline.

Swollen, sore joints (arthritis). People with Henoch-Schonlein purpura often have
painful, swollen joints mainly in the knees and ankles. Joint pain sometimes precedes
the classical rash by one or two days. These symptoms subside when the disease clears
and leave no lasting damage.

Gastrointestinal symptoms. Many children with Henoch-Schonlein purpura develop

gastrointestinal symptoms, such as abdominal pain, nausea, vomiting or bloody stools.
These symptoms sometimes occur before the rash appears.

Kidney involvement. Henoch-Schonlein purpura can also affect the kidneys. In most
cases, this shows up as protein or blood in the urine, which you may not even know is
there unless you have a urine test done. Usually this goes away once the illness passes,
but in a few cases, kidney disease may develop and even persist.

Causes
In Henoch-Schonlein purpura, some of the body's small blood vessels become inflamed, which
can cause bleeding in the skin, joints, abdomen and kidneys. Why this initial inflammation
develops isn't clear, although it may be the result of an overzealous immune system responding
inappropriately to certain triggers.

Nearly half the people who have Henoch-Schonlein purpura developed the disease after an upper
respiratory infection, such as a cold. Infectious triggers may include chickenpox, strep throat,
measles and hepatitis. Other triggers may include certain medications, food, insect bites or
exposure to cold weather
Risk factors
Factors that may increase the risk of developing Henoch-Schonlein purpura include:

Age. The disease affects primarily children and young adults with the majority of cases
occurring in children between 2 and 6 years of age.

Sex. Henoch-Schonlein purpura is slightly more common in boys than girls.

Race. White and Asian children are more likely to develop Henoch-Schonlein purpura
than black children are.

Time of year. Henoch-Schonlein purpura strikes mainly in autumn, winter and spring but
rarely in summer.

Complications
For most people, symptoms improve within a month, leaving no lasting problems. Recurrences
are fairly common, however.
Complications associated with Henoch-Schonlein purpura include:

Kidney damage. The most serious complication of Henoch-Schonlein purpura is kidney

damage. Occasionally the damage is severe enough that dialysis or a kidney transplant
may be needed.

Bowel obstruction. In rare cases, Henoch-Schonlein purpura can cause intussusception

a condition in which a section of the bowel folds into itself like a telescope, which
prevents matter from moving through the bowel.

Tests and diagnosis

A diagnosis of Henoch-Schonlein purpura is fairly easy to make if the classic rash, joint pain and
gastrointestinal symptoms are present. If some of these signs and symptoms are missing, your
doctor may suggest one or more of the following tests.
Lab tests
Although no single test can confirm Henoch-Schonlein purpura, certain tests can help rule out
other diseases and make a diagnosis of Henoch-Schonlein seem likely. They may include:

Blood tests. People who have Henoch-Schonlein purpura often have abnormal levels of a
particular type of antibody in their blood.

Urine tests. Your urine may be tested for evidence of blood and to determine if your
kidneys are still working properly.

Treatments and drugs

Henoch-Schonlein purpura usually improves on its own within a month with no lasting ill
effects. Bed rest, plenty of fluids and over-the-counter pain relievers may help.
Medications
The use of powerful corticosteroids, such as prednisone, in treating or preventing complications
of Henoch-Schonlein purpura is controversial. They're most often used to treat severe
gastrointestinal symptoms. Because these drugs can have serious side effects and their usefulness
isn't clear, be sure to discuss the risks and benefits with your doctor.
Surgery
If a section of the bowel has folded in upon itself or ruptured, surgical repair will be necessary.
Lifestyle and home remedies
Children and adults with mild Henoch-Schonlein purpura should be kept comfortable while the
disease runs its course. Bed rest, plenty of fluids and over-the-counter pain relievers may help.

Erika Joyce C. Manubay

Bsn 3-2