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Henoch-Schonlein Purpura in Children

Henoch-Schonlein purpura in children is a disorder that causes inflammation in the blood vessels. This disorder is most common in children and rarely affects adults, although when it does it behaves in the same way. The inflammation can cause the capillaries in the skin, kidneys, joints, and intestines to bleed. The most common area affected is the skin, which causes only minor problems. More serious complications can arise if the kidneys and intestines are affected.

  1. Symptoms

    • Not all children will present with the same symptoms, however, three symptoms are typical in patients suffering from Henoch-Schonlein purpura. Purpura describes the dark red to purple spots that look much like bruises. This is the most common symptom of the disorder. The rash is typically found on the buttocks, feet, and legs but may also be present on the face, arms, or trunk of the body. Anywhere pressure is applied to the skin, such as the waistband of underwear or the elastic tops of socks may make the rash worse. Joint swelling is also a problem with this disorder. Many patients will have pain associated with joint swelling, primarily in the ankles and knees. About half of the children suffering from this disorder will also have abdominal pain that may be accompanied by vomiting, bloody stools and nausea.

    Causes

    • The initial cause of Henoch-Schonlein purpura in children isn't clear. The immune system appears to inappropriately respond to external triggers causing the inflammation, however the trigger is not the same in all patients and sometimes none of the usual triggers will have been experienced by the child. Some of the suspected triggers include upper respiratory infections, viral infections, bacterial infections, medications, insect bites, some chemicals, cold weather, exposure to a food allergen, and some vaccinations.

    Risk Factors

    • Henoch-Schonlein purpura is most common in children between the ages of two and eleven; however, it is possible for young adults to be affected as well. The disorder is more common in boys and in white or Asian children. The disorder typically occurs in the spring or autumn and is almost never found in the summer. Children who have recently suffered a respiratory illness or other viral or bacterial infection are also at an increased risk of developing the disorder.

    Tests

    • There is no single test that is able to diagnose the disorder, instead, tests are often used to rule out other conditions. A physical exam is the primary diagnostic tool although other tests may include a blood test, skin biopsy, and urine tests. The blood test will look for an increase in the level of IgA or the erythrocyte sedimentation rate. A urine analysis will determine the affect of the disease on the kidneys. A skin biopsy may be required when other tests are inconclusive.

    Treatment

    • Fortunately, Henoch-Schonlein purpura in children is usually a mild disorder that resolves on its own within four to six weeks. Treatment will focus on relieving symptoms rather than curing the disorder. Typically this involves bed rest, fluids, and occasional NSAIDS to relieve pain and inflammation.

      Hospitalization is indicated only if the patient is having difficulty remaining hydrated, has internal bleeding, is suffering from inflammation that severely restricts movement, or develops serious complications involving the kidneys.

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