Although HSP can affect people at any age, most cases occur in children between the
ages of 2 and 11. It is more common in boys than girls. Adults with HSP are more
likely to have more severe disease compared to children.
HSP usually ends after four to six weeks -- sometimes with recurrence of symptoms
over this period, but with no long-term consequences (recurrences are fairly
common). If organs such as the kidneys and intestines are affected, treatment is often
needed and it is important to have regular follow-up to prevent serious complications.
Causes and Risk Factors for Henoch-Schonlein
Purpura
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Henoch-Schonlein purpura. Henoch-Schonlein purpura (HSP) is a disease that
involves inflammation which causes blood vessels in the skin, intestines, kidneys,
and joints to start leaking. The main symptom is a rash with numerous small
bruises, which have a raised appearance, over the legs or buttocks. Other
symptoms can include joint and abdominal pain as well as kidney impairment.
HSP most commonly occurs in children and in boys more than girls. Adults who
develop it generally experience more severe cases.
The exact cause of HSP is not known. The body's immune system is believed to play
a role in targeting the blood vessels involved. An abnormal immune response to an
infection may be a factor in many cases. Approximately two-thirds of the cases of
HSP occur days after symptoms of an upper respiratory tract infection develop.
Some cases of HSP have been linked to vaccinations for typhoid, cholera, yellow
fever, measles, or hepatitis B; foods, drugs, chemicals, and insect bites. Some experts
also say that HSP is associated with the colder weather of fall and winter.
Symptoms of Henoch-Schonlein Purpura
The classic symptoms of HSP are rash, joint pain and swelling, abdominal pain,
and/or related kidney disease, including blood in urine. Before these symptoms begin,
patients may have two to three weeks of fever, headache, and muscular aches and
pains. Rarely, other organs, such as the brain, lungs, or spinal cord may be affected.
Rash. The rash usually appears in all patients with
HSP. The initial appearance may resemble hives, with
small red spots or bumps on the lower legs,
buttocks, knees, and elbows. But these change to
appear more like bruises. The rash usually affects
both sides of the body equally and does not turn pale
on pressing.
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Arthritis. Joint inflammation, involving pain and
swelling, occurs in approximately three-quarters of
cases, particularly affecting the knees and ankles. It
usually lasts only a few days and does not cause any
long-term, chronic joint problems.
Abdominal pain. In more than half of people with
HSP, inflammation of the gastrointestinal tract
may cause pain or cramping; it may also lead to loss
of appetite, vomiting, diarrhea, and occasionally
blood in the stool.
In some cases, patients may have abdominal pain
before the rash appears. In rare cases, an abnormal
folding of the bowel (intussusception) may cause a
bowel blockage, which may require surgery to fix.
Kidney impairment. HSP can cause kidney
problems, indicated by such signs as protein or blood
in the urine. This is usually only discovered on urine
testing, since it does not generally cause any
discomfort.
In most patients, the kidney impairment is mild and
goes away without any long-term damage. It's
important to monitor the kidney problems closely and
make sure they clear up, since about 5% of patients
may develop progressive kidney disease. About 1%
may go on to develop total kidney failure.
