When Your Child Has Henoch-Schönlein Purpura (HSP)
Henoch-Schönlein purpura (HSP) is a condition that causes swelling and inflammation of small blood vessels. The swollen blood vessels leak blood into the skin, joints, intestines, and kidneys. HSP occurs most often in children between ages 2 and 6. It occurs more often in boys. The disease can happen in siblings of the same family. Most children with HSP recover fully. But some children may have kidney problems.
How to say it
HEH-nohk SHOHN-lin PER-per-uh
What causes HSP?
HSP is an autoimmune disorder. This is when the body’s immune system attacks the body’s own cells and organs. With HSP, this immune response may be linked to an upper respiratory tract infection. Other immune triggers may include an allergic reaction, medicine, injury, or being out in cold weather.
Symptoms of HSP
Each child’s symptoms can vary. Common symptoms include:
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A rash caused by blood leaking into the skin
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Blood leaking into mucous membranes, internal organs, and other tissues
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Joint pain and swelling (arthritis)
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Belly (abdominal) pain
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Bleeding in the digestive tract, which includes the mouth, esophagus, stomach, and intestines
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Swollen kidneys
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Swelling just below the skin
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Inflammation of the testicles
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High blood pressure
Diagnosing HSP
Your child’s healthcare provider will ask about your child’s health history and do a physical exam. Diagnosis is based on symptoms such as:
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Joint pain and swelling
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A rash
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Belly pain
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Kidney disease
Your child may also need tests, such as:
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Biopsy. The provider may take small tissue samples. They may be taken from the skin or the kidney. They are looked at under a microscope. This may only be needed if the diagnosis is unclear.
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Blood and urine tests. Your child's urine will be checked for blood and protein. A blood test can check kidney function.
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Ultrasound. This imaging test uses sound waves and a computer to make pictures of blood vessels, tissues, and organs. It may be used to look at the digestive tract for signs of the disease.
Treatment for HSP
Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is. Treatments for HSP may include:
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Making sure your child drinks enough fluids
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Making sure your child eats a healthy diet
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Medicines such as acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDS) to help ease pain
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Glucocorticoid medicine to control inflammation
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Medicine to lower blood pressure if needed
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Natural supplements such as fish oil and antioxidants
Talk with your child’s healthcare provider about the risks, benefits, and possible side effects of all medicines.
Possible complications of HSP
Most children with HSP recover fully. But some children may have kidney damage. For this reason it's important for a child with HSP to have repeat urine tests and to measure their blood pressure often. This should be done for a few weeks or months after diagnosis, even if there's no early evidence of kidney damage. In rare cases, a child may have kidney failure. Women who've had HSP as a child have a higher risk for pregnancy-induced hypertension (pre-eclampsia).
When to call your child’s healthcare provider
Call the healthcare provider if your child has any of these: