Henoch schonlein purpura hsp is a small vessel vasculitis that is characterized by nonthrombocytopenic purpura, abdominal pain, arthritis, and glomerulonephritis. Clinical course of extrarenal symptoms in henoch schonlein purpura. Henoch schonlein purpura hsp is a disease that causes small blood vessels to become inflamed and leak blood. Gastrointestinal sonographic findings in henochschonlein purpura. Purpura, arthritis, and abdominal pain are known as the classic triad of henochschonlein purpura. Henochschonlein purpura anaphylactoid purpura, vascular purpura internal medicine an acquired form of small vessel vasculitis with igadominant immune deposits affecting small vesselsarteries, capillaries, venules, typically of the skin, gut, and glomeruli, associated with arthralgia andor arthritis. Henochschonlein purpura hsp is a systemic vasculitis involving small vessels with the deposition of immune complexes containing iga.
In 1899, henoch also described the association between purpura and renal involvement 2. It has been extensively studied in children, but in adults, its natural history is much less known. Henoch schonlein purpura occurs mostly in autumn, spring, and winter but rarely in the summer. The prognosis for patients with henoch schonlein purpura is generally excellent. However, all four elements of this tetrad are not required for diagnosis.
Hsp may appear after a remote history of infection often an upper respiratory tract infection as a rash with palpable petechiae or purpura. Henoch schonlein purpura hsp is defi ned as a primary systemic vasculitis of small vessels char acterized by predominantly iga immune deposits on the walls of the capillaries, venules, and. The full text of this article is available in pdf format. The small vessels of the skin, joints, kidneys, and digestive organs are particularly involved. Then 37 years later, in 1874, henoch discovered its association with abdominal pain. Although hsp can affect people at any age, most cases occur in children between the ages of 2 and 11. Symptoms can begin in children, most commonly between the ages of 4 and 7 years, soon after an upper respiratory tract infection or a. Also known as allergic purpura, anaphylactoid purpura, and schonleinhenoch syndrome. This vasculitic syndrome can present as an uncommon cause of rectal bleeding in older patients. The peak incidence is between the ages of 4 years and 8 years with a male preponderance.
Henoch schonlein purpura is a nongranulomatous small vessel vasculitis that is characterized by deposition. Its incidence is low in childhood with the exception of henoch schonlein purpura hsp and. He presented with rectal bleeding and acute kidney injury secondary to. The american college of rheumatology 1990 criteria for the classification of henoch schonlein purpura. Intravenous cyclophosphamide therapy in adults with henoch. We report a case of an older man with henochschonlein purpura. Kelainan ini pertama kalinya dikemukakan oleh johan schonlein pada tahun 1837 berupa adanya kelinan pada kulit dan nyeri pada sendi, sedangkan edward henoch menggambarkan adanya kelaian pada gastrointestinal dan manifestasi ginjal pada tahun 1868 sehingga untuk mengenang nama beliau ini penyakitnya dinamakan henoch schonlein purpura. The disease is characterized by abnormal deposits of immunoglobulin a an antibody in the blood vessels, leading to their inflammation vasculitis.
Tonsillectomy was an alternative mean to treat hsp children with chronic tonsillitis. Protocolos diagnosticos y terapeuticos en pediatria. Henoch schonlein purpura usually goes away on its own within a month with no lasting ill effects. Jan 17, 2015 henoch schonlein purpura refers to an acute or chronic vasculitis affecting primarily small vessels of the skin, joints, g. Henoch schonlein purpura is a disease that involves purple spots on the skin, joint pain, gastrointestinal problems, and glomerulonephritis a type of kidney disorder. A 57yearold woman presented with classical symptoms of henoch schonlein purpura including arthralgia, abdominal pain, palpable purpuric rash and abnormalities of the urinary sediments. Central nervous system cns involvement in henoch schonlein purpura hsp is rare but poses diagnostic difficulties.
Henochschonlein purpura hsp is a vasculitis inflammation of blood vessels that affects small blood vessels mainly in the skin, intestines, and kidneys. Jul 26, 2017 henochschonlein purpura hsp is a disease that causes small blood vessels to become inflamed and leak blood. Purpura occur in all cases, joint pains and arthritis in 80%, and abdominal pain in 62%. Henochschonlein purpura definition of henochschonlein. The disease primarily affects young children but may affect older children and adults. This page includes the following topics and synonyms. The american college of rheumatology 1990 criteria for the classification of henoch schonlein purpura mills ja, michel ba, bloch da, et al. Dec 10, 2018 henoch schonlein purpura hsp, also called immunoglobulin a vasculitis igav, is a vascular disease that primarily affects small blood vessels. Paciente con purpura cutanea monica rodriguez carballeira. Frequently, hsp leads to abdominal pain and intestinal bleeding, renal involvement and joint pain. Henochschonlein purpura is a small vessel vacuities in which complexes of immunoglobulin a iga and complement component 3 c3 are deposited on arterioles, capillaries, and venules.
Henoch in 1868 reported the first case of a patient with colic, bloody diarrhea, painful joints, and a rash. Schonleinhenoch purpura, anaphylactoid purpura rhumatoid purpura diagnosis diagnosis of hsp is established when at least 2 of the following 4 criteria are present. A diagnosis of henochschonlein purpura is fairly easy to make if the. Hsp is most common in younger pts clinical red maculopapules on legs and buttocks. Henochschonlein purpura hsp is vasculitis of the small vessels, the most common vasculitis of the childhood and is uncommon in adults. The tetrad of purpura, arthritis, kidney inflammation, and abdominal pain is often observed. The diagnosis of this disease is usually not hard to make because of the rash which is classic, gastrointestinal symptoms and joint pain being present.
Central nervous system involvement in henochschonlein. Further investigations may be required if the diagnosis is unclear, abdominal symptoms are severe or where there is evidence of significant renal involvement hypertension, macroscopic haematuria or proteinuria. Henoch schonlein purpura, chronic tonsillitis, rash, 24h urine protein, tonsillectomy introduction henoch schonlein purpura hsp is a common capillary allergic disease in children. Henochschonlein purpura israel pdf ppt case reports. Henoch schonlein purpura, nephritis, therapy, children introduction henoch schonlein purpura hsp is an immunologically mediated disease associating purpura plus urticaria, characteristically affecting lower limbs, buttocks, and elbows. Henoch schonlein purpura causes skin rash, pain in the abdomen, and joint inflammation. Henoch schonlein purpura hsp is a usually temporary problem of the microcirculation of the body blood vessels, and often follows a chest infection or similar illness. Iga vasculitis, formerly henochschonlein purpura, is a form of vasculitisa family of rare disorders characterized by inflammation of the blood vessels, which can restrict blood flow and damage vital organs and tissues. Henochschonlein purpura is a systemic vasculitis of the small vessels characterized by. It gets its name from two german doctors, johann schonlein and eduard henoch, who. Henochschonlein purpura guidelines bmj best practice. Original article relationship between chronic tonsillitis and. Urinalysis is the only investigation required in a classic presentation of hsp.
Typically, hsp is selflimited requiring only supportive care, but more severe cases may require corticosteroid cs. A case of henochschonlein purpura hs p gwyneth evans. Medical files of patients with hsp admitted at the department of pediatrics, plovdiv, were studied retrospectively for a fiveyear. The treatment of henoch schonlein purpura is directed toward the most significant area of involvement. Patients present with a rash purpura caused by small hemorrhages in the skin. Alfredo cs1, nunes na, len ca, barbosa cm, terreri mt, hilario mo. Pdf on feb 1, 2019, sonia mastrapasqua and others published purpura schonlein henoch find, read and cite all the research you need on researchgate. In the skin, the disease causes palpable purpura small, raised areas of bleeding. Some include gastrointestinal hemorrhage as a fourth criterion. The objective of this study was to document the spectrum of sonographic findings in the gastrointestinal tract of children with abdominal pain due to henochschonlein purpura.
Purpura, henoch schonlein, henoch scholein purpura, purpuras, schonlein henoch expand a systemic nonthrombocytopenic purpura caused by hypersensitivity vasculitis and deposition of igacontaining immune complexes within the blood. Henoch schonlein purpura is an inflammation of the small blood vessels of the skin, joints, bowels and kidneys. Dec 11, 2018 schonleins name should come first because he was the first person to recognize the condition and did so in 1837. Please use one of the following formats to cite this article in your essay, paper or report. Henoch schonlein purpura hsp is an immunologically mediated disease associating purpura plus urticaria, characteristically affecting lower limbs, buttocks, and elbows. Henochschonlein purpura in an older man presenting as rectal. Henoch schonlein purpura, henoch schonlein purpura, henoch schoenlein purpura, henoch schoenlein purpura, hsp, iga vasculitis, immunoglobulin a vasculitis. All structured data from the file and property namespaces is available under the creative commons cc0 license. The american college of rheumatology 1990 criteria for the classification of henoch schonlein purpura external link opens in a new window mills ja, michel ba, bloch da, et al. The abdominal ultrasound images of consecutive patients with henochschonlein purpura were retrospectively analyzed, with special attention to the following findings. Henochschonlein purpura is the most common systemic vasculitis in children. An acute respiratory infection precedes purpura in a high proportion of affected young children.
Henochschonlein purpura allergy and clinical immunology. Henoch schoenlein purpura hsp is a systemic vasculitis inflammation of blood vessels that is due to deposits of the antibody iga in the small vessels and kidneys. When blood vessels get inflamed, they can bleed into the skin, causing a reddishpurple rash purpura. As with iga nephropathy, serum levels of iga are high in hsp and there are identical findings on renal biopsy. Henoch schonlein is caused by an abnormal response of the immune system. Schonleinhenoch purpura hsp is a systemic vasculitis that affects vessels of a small calibre. Rest, plenty of fluids and overthecounter pain relievers may help with symptoms.
Typical presentations are palpable purpura, abdominal pain, arthritis, and hematuria. The iga deposits in vessel walls, associated with the. Files are available under licenses specified on their description page. Henochschonlein purpura hsp, also called immunoglobulin a vasculitis igav, is a vascular disease that primarily affects small blood vessels. Henochschonlein purpura diagnosis and treatment mayo clinic.
Therapy for children with henochschonlein purpura nephritis. Henochschonlein purpura hsp, the commonest childhood vasculitis, is characterised by nonthrombocytopaenic palpable purpura, arthritis or arthralgias, gastrointestinal and renal involvement. Vasculitis espanol american college of rheumatology. Purpura not due to a low platelet count, caused by inflammation in blood vessels of the skin, is the hallmark of hsp. Henoch schonlein purpura hsp is a common leukocytoclastic vasculitis seen in.