Overview

Henoch-Schönlein purpura (HSP) is a condition that involves swelling (inflammation) of small blood vessels. The swollen blood vessels leak into the skin, joints, intestines, and kidneys. HSP is seen most often in children between the ages of 2 and 6. It occurs more often in boys. The disease can happen in siblings of the same family. Most children with HSP recover fully. But some children may have kidney problems.

Causes

HSP is an autoimmune disorder. This is when the body’s immune system attacks the body’s own cells and organs. With HSP, this immune response may be caused by an upper respiratory tract infection. Other immune triggers may include an allergic reaction, medicine, injury, or being out in cold weather.

Symptoms

Each child’s symptoms can vary. Common symptoms include:

  • A rash caused by blood leaking into the skin
  • Blood leaking into mucous membranes, internal organs, and other tissues
  • Joint pain and swelling (arthritis)
  • Belly (abdominal) pain
  • Bleeding in the GI (gastrointestinal) tract, which includes the mouth, esophagus, stomach, and intestines
  • Swollen kidneys
  • Swelling just below the skin
  • A brain disorder
  • Inflammation of the testicles

These symptoms can seem like other health conditions. Make sure your child sees his or her healthcare provider for a diagnosis.

Diagnosis

Your child’s healthcare provider will take your child’s medical history and do a physical exam. Diagnosis is based on symptoms such as:

  • Joint pain and swelling (arthritis)
  • A rash
  • Belly pain
  • Kidney disease

Tests may also be done, such as:

  • Biopsy. Small tissue samples may be taken. They may be taken from the skin or the kidney. They are looked at with a microscope. This is may only be needed if the diagnosis is unclear.
  • Blood and urine tests. Your child's urine will be checked for blood and protein. A blood test can check kidney function.
  • Ultrasound. This imaging test uses sound waves and a computer to make pictures of blood vessels, tissues, and organs. It may be used to look at the GI tract for signs of the disease.

Treatment

Your child's healthcare provider will figure out the best treatment plan for your child based on:

  • How old your child is
  • Your child’s overall health and medical history
  • How sick your child is
  • How well your child handles certain medicines, treatments, or therapies
  • If your child’s condition is expected to get worse
  • The opinion of the healthcare providers involved in your child's care
  • Your opinion and preference

Treatments for HSP may include:

  • Making sure your child drinks enough fluids
  • Making sure your child eats a healthy diet
  • Taking medicines such as acetaminophen to help lessen pain
  • Taking glucocorticoids to control inflammation
  • Taking blood pressure medicine to lower blood pressure if needed

Talk with your child’s healthcare provider about the risks, benefits, and possible side effects of all medicines.

Complications

Most children with HSP recover fully. But some children may have kidney damage. In rare cases, a child may have kidney failure. Women who have had HSP as a child have a higher risk of pregnancy-induced hypertension (pre-eclampsia).

When to Call a Healthcare Provider

Tell the healthcare provider if your child’s symptoms get worse or there are new symptoms.

Key Points

  • Henoch-Schönlein purpura (HSP) is a condition that involves swelling (inflammation) of small blood vessels.
  • The swollen blood vessels leak into the skin, joints, intestines, and kidneys.
  • It is seen most often in children between the ages of 2 and 6. It occurs more often in boys.
  • HSP is an autoimmune disease that is often triggered by an upper respiratory infection.
  • Symptoms include a rash caused by bleeding under the skin, arthritis, belly pain, and kidney disease.
  • Most children recover fully. But some children may have kidney problems.

Next Steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.