Henoch-schonlein purpura

Description

Henoch-schonlein purpura (also known as IgA vasculitis) is a disorder that causes the small blood vessels in the skin, joints, intestines, and kidneys to become inflamed and bleed.

The most striking feature of this form of vasculitis is a rash of purple, usually in the lower part of the legs and buttocks. Henoch-schonlein purpura can also cause abdominal pain and pain in the joints. Rarely, serious kidney damage can occur.

Henoch-schonlein purpura can affect anyone, but is most common in children under the age of 10 years. The condition usually improves on its own. Medical attention is required if the disorder affects the kidneys.

Symptoms

The four main features of Henoch-schonlein purpura include:

  • Skin rash (purpura). Reddish-purple spots that look like bruising on the buttocks, legs and feet. The rash can also appear on the arms, face and trunk and may be worse in areas of pressure, such as the sock line and the waist.
  • Swollen, pain in the joints (arthritis). People with Henoch-schonlein purpura often have pain and swelling around the joints, mainly in the knees and ankles. Pain in the joints, sometimes precedes the classic rash for a week or two. These symptoms disappear when the condition is cleared and does not leave any lasting damage.
  • The digestive tract of the symptoms. Many children with Henoch-schonlein purpura develop abdominal pain, nausea, vomiting, and blood in the stool. These symptoms sometimes occur before the rash appears.
  • The renal involvement. Henoch-schonlein purpura can also affect the kidneys. In most cases, this is shown as a protein or blood in the urine, which you may not even know it is there unless you have a urine test done. Usually this disappears once you pass the disease, but some people develop persistent kidney disease.

When to see a doctor

Consult your doctor if you have Henoch-schonlein purpura and this is causing serious problems with the digestive tract.

If your child develops the rash associated with this condition, consult your doctor as soon as possible.

Causes

In Henoch-schonlein purpura, some of the small blood vessels are inflamed, which can cause bleeding in the skin, abdomen, and kidneys. It is not clear why this initial inflammation develops. It may be the result that the immune system responds inappropriately to certain triggers.

Almost half of the people who have Henoch-schonlein purpura developed after an upper respiratory tract infection such as a cold. Other factors include chicken pox, strep throat, measles, hepatitis, certain medications, foods, insect bites and exposure to cold weather.

Risk factors

The factors that increase the risk of developing Henoch-schonlein purpura include:

  • Age. The disease mainly affects children under the age of 10.
  • Sex. Henoch-schonlein purpura is slightly more common in men than in women.
  • Of the race. Whites and Asians are more prone to the development of Henoch-schonlein purpura that are black children.

Complications

For most people, symptoms improve within a month, leaving no lasting problems. But recurrences are quite common.

The complications associated with Henoch-schonlein purpura include:

  • The kidney damage. The most serious complication of Henoch-schonlein purpura is the kidney damage. This risk is higher in adults than in children. Sometimes the damage is so severe that the dialysis or a kidney transplant is necessary.
  • Intestinal obstruction. In rare cases, Henoch-schonlein purpura may cause intussusception — a condition in which a section of the intestine is folded into itself like a telescope, which prevents the material it moves through the intestine.

Henoch-schonlein purpura

Diagnosis

Your doctor will be able to diagnose the condition as Henoch-schonlein purpura if the classic rash, joint pain and digestive tract symptoms are present. If one of these signs and symptoms of failure, your doctor may suggest one or more of the following tests.

Laboratory tests

No laboratory test can confirm the Henoch-schonlein purpura, but certain tests can help rule out other diseases and to make a diagnosis of Henoch-Schonlein purpura seems likely. They may include:

  • Blood tests. Your blood can be tested if the diagnosis is not clear based on signs and symptoms.
  • Urine tests. Your urine can be tested by the evidence of the blood, proteins, or other abnormalities, to determine if your kidneys are still functioning correctly.

Biopsies

People who have Henoch-schonlein purpura often have deposits of a certain protein, IgA (immunoglobulin A), in the affected organ. Your doctor may take a small sample of the skin so that it can be tested in a laboratory. In cases of severe renal impairment, your doctor may suggest a kidney biopsy to help guide treatment decisions.

Imaging tests

Your doctor may recommend an ultrasound to rule out other causes of abdominal pain and to check for possible complications, such as bowel obstruction.

Treatment

Henoch-schonlein purpura usually goes away within a month with no harmful effects. The rest, plenty of fluids and over-the-counter pain relievers may help with the symptoms.

Drugs

Corticosteroids, such as prednisone, can help to shorten the time and the intensity of the joint and abdominal pain. Because these drugs can have serious side effects, discuss the risks and benefits of using them with your doctor.

Surgery

If a section of the intestine is folded in on itself, or torn, surgery may be needed.

Self-care

Home care focuses on keeping people with a mild degree of Henoch-schonlein purpura comfortable while the disease runs its course. The rest, plenty of fluids and over-the-counter pain relievers can help.

Preparing for your appointment

It is likely that you first see your family doctor or your child's pediatrician for this condition. You may be referred to a kidney specialist (nephrologist) if the kidneys are developed complications. Here is some information that can help you prepare for your appointment.

What you can do

Before your appointment, write down the answers to the following questions:

  • When did the symptoms begin?
  • Arrived suddenly or gradually?
  • Was the person with the rash (you or your child sick before the eruption started?
  • What medications and supplements that are done by the person with the rash of regularly take?

The questions that you can ask your doctor include:

  • What could be the cause of these symptoms?
  • What are the tests needed to confirm the diagnosis?
  • Is this condition temporary or chronic?
  • How do I know if there is kidney damage? What if it turns out until later?
  • How is Henoch-schonlein purpura is this?
  • What are the side effects of treatment?
  • Do you have any literature on this condition? Can you recommend a website where I can learn more?

What to expect from your doctor

Your doctor is likely to ask a series of questions, such as:

  • What did the eruption of look when she first started?
  • It is the painful rash? Do they bite?
  • Does the person with the rash and other symptoms, such as stomach pain or joint pain?
Symptoms and treatment of Henoch-schonlein purpura