Schonlein henochova purpura

This helps to detect any signs of developing chronic kidney disease early.

Frequently Asked Questions (FAQs)

How long does Henoch-Schönlein purpura (HSP) take to heal?

The typical healing time for Henoch-Schönlein Purpura (HSP) is 4 to 8 weeks in most children.

Is Henoch-Schönlein purpura (HSP) itchy?

Yes, the rash associated with Henoch-Schönlein Purpura (HSP) can be itchy (pruritic) for some individuals, but it’s not the primary or most prominent symptom.

Does Henoch-Schönlein Purpura (HSP) get worse at night?

Medical literature on Henoch-Schönlein Purpura (HSP) doesn’t typically highlight a consistent pattern of symptoms worsening specifically at night.

PMID: 29136340 pubmed.ncbi.nlm.nih.gov/29136340/.

Updated by: Diane M. Horowitz, MD, Rheumatology and Internal Medicine, Northwell Health, Great Neck, NY. Review provided by VeriMed Healthcare Network. Elevated BUN and creatinine levels indicate impaired renal function. Much of the difference between the two disease processes results from IgAV being predominantly a disease of children and IgA nephropathy being primarily a disease of adults.[2][3]

Etiology

Environmental, genetic, and antigenic factors appear to contribute to the etiology of IgA vasculitis.

In rare cases of end-stage renal disease, dialysis or kidney transplantation may be necessary.  

Prognosis

The prognosis of Henoch-Schönlein Purpura (HSP) is generally very good, especially in children, which is the most commonly affected population. These potential triggers suggest that Henoch-Schönlein purpura (HSP) is likely a multifactorial disease in individuals with a genetic predisposition.

• Infections: Upper Respiratory Tract Infections (URTIs) is the most frequently reported preceding event, occurring in up to 50-75% of cases.
  
  

  The mean age of patients with HSP is 5.9 years.

  What causes Henoch-Schönlein Purpura?

  In two-thirds of the cases, the disease follows an upper respiratory tract infection, with onset an average of ten days after the start of respiratory symptoms. doi: 10.12659/MSM.943912. 2022;13:921864. The complement system can also be activated when C3-receptor lymphocytes bind to immune complexes and deposit in the vessel walls, contributing to the hyper-inflammatory response.

  Smaller joints of the hands and feet can also be involved.

  The joint pain can range from mild discomfort (arthralgia) to frank arthritis with swelling, tenderness, and limited range of motion.

  The arthritis is often migratory and transient, meaning it can affect different joints at different times and usually resolves within days to weeks without causing permanent joint damage.  

  Abdominal Pain

  Gastrointestinal involvement is a significant aspect of Henoch-Schönlein purpura and can be quite distressing.

  The rash typically begins as small, red spots (petechiae) or raised bumps (papules) that quickly evolve into palpable purpura. 

  The purpura characteristically appears in gravity-dependent areas, such as the lower extremities (legs and ankles) and buttocks. Nomenclature of cutaneous vasculitis: Dermatologic addendum to the 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides.

  In this case, the “trauma” was caused by the patient’s shaving of her legs, leading to the eruption of purpura in the area of skin where the razor had passed. Steroids, however, do not appear to improve the rash; although usually, over weeks to months, the recurrent bouts of purpura usually resolve on their own.

  Living With HSP

  Supportive care may involve a short course of prednisone or an NSAID, such as naprosyn or ibuprofen, if the kidneys are not involved.

  Close monitoring is advisable.  

• Acetaminophen (Paracetamol): Can be used for pain relief and fever control, especially if there are concerns about using NSAIDs.

Medications for Specific Manifestations

• Corticosteroids: Systemic corticosteroids (e.g., prednisone or prednisolone) may be considered for more severe symptoms, such as significant abdominal pain that doesn’t respond to NSAIDs, severe joint involvement limiting mobility, or severe scrotal pain and swelling.
• Immunosuppressants: Immunosuppressive agents (e.g., azathioprine, mycophenolate mofetil, cyclophosphamide) are generally reserved for patients with severe or progressive renal disease (e.g., nephritic syndrome, significant proteinuria, declining renal function) that is not responding to corticosteroids alone.

  The symptoms tend to fluctuate throughout the day, often related to activity levels (e.g., joint pain might be worse after activity).

  In summary, while some individuals with  Henoch-Schönlein Purpura (HSP) might subjectively feel that their symptoms, particularly pain, are worse at night, this isn’t a universally reported characteristic of the disease.

  Surgical intervention is necessary if non-surgical methods fail or if there are signs of bowel ischemia or perforation.

• Gastrointestinal Bleeding: Management depends on the severity. IgAV has also been seen with COVID-19 immunizations.[8]

Epidemiology

IgAV is a rare disorder that typically affects children; however, the condition can also be seen in adults and adolescents.

The benefits of vaccination far outweigh the rare potential risk of triggering Henoch-Schönlein purpura (HSP).