Henoch-Schonlein purpura (HSP) or immunoglobulin A (IgAV) vasculitis is inflammation of the small blood vessels in the skin, joints, intestines, and kidneys. This disorder can cause symptoms red or purple rash (purpura) on the skin in the area of the lower legs or buttocks.
HSP is quite rare. This condition is generally experienced by children under the age of 11 years. HSP is not contagious and does not run in families. Most people with HSP recover within a few weeks.
Causes of Henoch-Schonlein Purpura
Henoch-Schonlein purpura or immunoglobulin A (IgAV) vasculitis is an inflammation of the blood vessels that most often occurs in children, especially those aged 2–11 years or male.
The exact cause of Henoch-Schonlein purpura (HSP) is not known. However, vascular inflammation in HSP is thought to be closely related to an abnormal immune system response to infection.
This abnormal immune system response will cause inflammation of the blood vessels. Then there will be bleeding and the appearance of a red or purple rash (purpura) on the skin.
In many cases, HSP occurs after the sufferer has an upper respiratory tract infection. In addition, this condition has also been associated with chickenpox, measles, hepatitis, vaccinations, insect bites, drug use, or exposure to cold temperatures.
Symptoms of Henoch-Schonlein Purpura
The main symptoms of HSP are the appearance of a red or purple rash on the skin (purpura), inflammation and swelling of the joints (arthritis), disorders of the digestive system, and disorders of the kidneys.
The following is a breakdown of the symptoms and complaints that can occur when someone has HSP:
- A red or purple skin rash (purpura) that most often appears on the arms and legs
- Pain and swelling in the joints
- Abdominal pain or cramps
- Nausea or vomiting
- Bloody defecation (CHAPTER)
- Diarrhea or constipation
- Decreased appetite
- Bloody urine
- Headache
- Fever
- Unexplained fatigue
When to go to the doctor
Check with your doctor if you have any of the symptoms or complaints mentioned above. Immediately see a doctor if you experience a rash on the skin accompanied by joint pain and swelling, as well as abdominal pain.
Because HSP can recur, HSP sufferers need to continue to have regular check-ups with the doctor even though they have recovered. An examination to the doctor also needs to be done if HSP complaints reappear.
Diagnosis of Henoch-Schonlein Purpura
To diagnose Henoch-Schonlein purpura (HSP), the doctor will ask questions about the symptoms you are experiencing, then perform a physical examination to look for purpuric skin rashes, joint swelling, and stomach disorders.
To confirm the diagnosis and determine the severity of the disease, the doctor will also perform the following investigations:
- Urine examination, to determine the presence or absence of protein and blood in the urine
- Stool examination, to determine whether there is blood in the stool
- Blood tests, to detect signs of infection and assess kidney function
- Ultrasound scans of the abdomen and kidneys, to see the condition of the digestive system and kidneys, including to identify the cause of abdominal pain and the presence or absence of complications, such as bleeding in the intestines
- Skin and kidney biopsies, to detect a buildup of immunoglobulin A (IgA) protein
Henoch-Schonlein Purpura Treatment
Complaints experienced by patients with Henoch-Schonlein purpura (HSP) will usually subside and go away on their own after 6-8 weeks. Therefore, doctors will only advise patients to rest, drink enough water, and take pain medication.
Some types of drugs that can be given by doctors to relieve complaints and symptoms of HSP are:
- Antipyretic-analgesic drugs, such as paracetamol and nonsteroidal anti-inflammatory drugs, to relieve fever and joint pain
- Corticosteroids, such as prednisone, to relieve stomach pain and arthritis
Although it gets better on its own, HSP can come back. That is why, people with HSP are advised to keep a check on the doctor and undergo regular urine and blood tests. The goal is to assess kidney function and monitor the patient's condition. The examination will be carried out for 6-12 months and can be stopped if no problems are found.
If the HSP experienced is severe enough or has caused complications, the patient may need to be hospitalized. Surgery may also be necessary if the HSP has resulted in the intestines being folded (intussusception) or ruptured.
ComplicationsHenoch-Schonlein Purpura
Although quite rare, Henoch-Schonlein purpura (HSP) can cause the following complications:
- Kidney disorders
- Bleeding in the intestines
- Orchitis
- Intussusception
Although rare, HSP can also cause complications such as seizures, bleeding in the lungs, and heart attacks.
Prevention of Henoch-Schonlein Purpura
Henoch-Schonlein purpura (HSP) cannot be prevented. What can be done to reduce the risk of this condition is to prevent viral and bacterial infections. One of them is by implementing a clean and healthy lifestyle. In addition, avoid the use of drugs that can cause immune system disorders.