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Diseases and Conditions
Henoch-Schonlein purpuraFrom MayoClinic.com
Special to CNN.com
Henoch-Schonlein purpura affects the small blood vessels of your skin, joints, intestines and kidneys, causing them to become inflamed and swollen (vasculitis).
Blood vessel inflammation can cause bleeding into your skin. For people with Henoch-Schonlein purpura, the bleeding causes a purplish skin rash (purpura) that can last up to several weeks.
Although Henoch-Schonlein purpura can affect anyone, it's most common in children ages 2 to 11, with 5 to 7 being the ages at which it's most likely to occur. It's the most common vasculitis that occurs in children. Boys are more likely to develop the condition than girls are, and it occurs less frequently in blacks than it does in whites or Asians.
In most cases, Henoch-Schonlein purpura improves on its own within four to six weeks. Medications may ease discomfort from some of the signs and symptoms of Henoch-Schonlein purpura.
Signs and symptoms
There are three primary signs and symptoms of Henoch-Schonlein purpura, although not everyone with the disease develops all three. They are:
These signs and symptoms may be accompanied by fever.
Although the cause of Henoch-Schonlein purpura isn't known, experts believe it to be most often triggered by an upper respiratory infection, such as a common cold. The blood vessel inflammation (vasculitis) may result from an overzealous immune system response to the triggering agent. Although the triggering agent may be contagious, Henoch-Schonlein purpura itself isn't.
Besides a common cold, other possible triggers include:
When to seek medical advice
Henoch-Schonlein purpura can cause inflammation of the blood vessels in any organ, including the intestines and kidneys. Rarely, serious problems of the bowel or kidneys can develop. So see a doctor if you or your child has the signs and symptoms of the disease, such as the characteristic rash, joint pain and swelling, and abdominal pain.
Screening and diagnosis
If you or your child has all three major indicators of Henoch-Schonlein purpura — rash, joint pain and abdominal pain — the diagnosis shouldn't be difficult. Without all three indicators, diagnosis can be challenging.
There isn't a single laboratory test that will confirm the diagnosis, but there are tests that can help rule out other diseases and lend support to a diagnosis of Henoch-Schonlein purpura. Besides conducting a physical exam and taking a medical history, your doctor may request several tests, including:
For most people with Henoch-Schonlein purpura, the signs and symptoms improve in a few weeks leaving no lasting problems. Up to one-third of those who get the condition will get it at least once again. Children who have a more severe form of the disease appear to be more likely to have a recurrence, but recurrences typically are milder than the initial disease.
Rarely, the disease damages kidneys. The disease affects most children's kidneys only mildly. However, some children and most adults who develop Henoch-Schonlein purpura experience more serious kidney involvement, leading to the kidneys' inability to remove waste from the blood. In extreme cases Henoch-Schonlein purpura can lead to kidney failure.
Also rare, if Henoch-Schonlein purpura affects the bowel, it can cause an obstruction (intussusception) that may require surgery to correct.
There's no treatment for Henoch-Schonlein purpura, which typically improves on its own within four to six weeks. If your doctor determines that the cause is a reaction to a medicine, then stopping the medicine will clear up the condition. Until the disease clears up, some medications may help ease discomfort:
If your child has Henoch-Schonlein purpura, try to keep him or her comfortable while the disease runs its course. Rest and NSAIDs as needed to relieve joint discomfort and swelling may help. Be sure to take your child for follow-up urine tests for as long as your doctor recommends.
November 03, 2006