Introduction
Henoch-Schönlein purpura (HSP) is a condition that causes inflammation of the small blood vessels in the:
- skin
- joints
- kidneys
- intestines.
HSP can happen in children of all ages but is most common between two and ten years old. It is not contagious but can be triggered by infection or viral illness, like a common cold.
Its cause is unknown.
Signs and symptoms
Signs and symptoms of HSP can develop over days to weeks. The most common symptom is a rash, called a purpura.
Purpura can be purple, spotty, or look like a bruise. It shows up around the bottom, legs and elbows.
Other symptoms can include:
- swelling of the feet, hands and scrotum
- pain in joints like the knees and ankles
- stomach pain, nausea and vomiting
- blood in your child’s poo and urine.
Intussusception
In rare cases, children with HSP may develop intussusception.
Intussusception is when the bowel slides or folds into itself, causing a blockage.
Intussusception is a medical emergency and needs surgery to fix.
Call Triple Zero (000) for an ambulance or go to your nearest emergency department if your child's vomit becomes a yellow or green colour.
This is a sign of blockage in the bowel, which can be life-threatening.
Diagnosis
Generally, HSP can be diagnosed by a doctor checking your child’s rash.
If your child is showing other symptoms without a rash, their doctor can order tests to check whether organs, like the kidneys, are working properly. This is to rule out any other cause of illness.
Tests can include:
- blood test
- urine tests
- biopsy - where a small sample of tissue is taken during surgery and tested
- ultrasound.
Treatment
HSP will usually go away on its own., with symptoms getting better within around four weeks.
Encourage your child to:
- rest
- drink plenty of fluids
- eat normally.
Over-the-counter pain relief like paracetamol or ibuprofen can be used for any discomfort or joint pain. Speak to your doctor if your child has stronger joint or abdominal pain, or if there are any sudden changes in their symptoms.
Management
Follow-up care
Children with HSP may have another episode within four months. The following episodes are usually shorter and milder. See your local doctor as soon you notice a new episode.
Most children with HSP can have their follow-up care managed by their local doctor. Follow-up care involves checking:
- how your child is recovering
- any signs of damage to their organs
- any signs or symptoms that mean another episode is happening.
Bowel and kidney problems
Children with severe HSP may develop bowel and kidney problems. Children with severe HSP can be referred to a specialist doctor, like a rheumatologist, for diagnosis, treatment, and management.