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Henoch-Schönlein purpura
Brian V Reamy1, Pamela M Williams, Tammy J Lindsay
1Department of Family Medicine at Uniformed Services University of Health Sciences in Bethesda, MD 20814, USA. breamy@usuhs.mil
American Family Physician
|October 13, 2009
Summary
Henoch-Schönlein purpura, a vasculitis affecting children and adults, often follows respiratory illness. Supportive care is typical, but corticosteroids may aid symptom resolution and prevent kidney issues.
Area of Science:
- Immunology
- Rheumatology
- Pediatrics
Background:
- Henoch-Schönlein purpura (HSP) is an acute, systemic immune complex-mediated leukocytoclastic vasculitis.
- It classically presents with palpable purpura, abdominal pain, and arthritis, often preceded by an upper respiratory infection.
- While most common in children under 10, adults may face increased complications.
Purpose of the Study:
- To summarize the clinical presentation, management, and prognosis of Henoch-Schönlein purpura.
- To evaluate the role of corticosteroids in managing HSP symptoms and renal involvement.
Main Methods:
- Review of clinical characteristics and treatment outcomes for Henoch-Schönlein purpura.
- Analysis of data regarding the efficacy of supportive care and corticosteroid therapy.
Main Results:
- All patients develop a purpuric rash; arthritis (75%), abdominal pain (60-65%), and renal disease (40-50%) are common.
- Supportive treatment is primary, with spontaneous resolution in most cases (94% in children, 89% in adults).
- Corticosteroids may reduce abdominal pain duration and the risk of persistent renal disease in children.
Conclusions:
- Henoch-Schönlein purpura typically resolves spontaneously, necessitating supportive care.
- Corticosteroid therapy can be beneficial for symptomatic relief and potentially mitigating renal complications.
- Prognosis is largely determined by the severity of renal involvement, with end-stage renal disease occurring in 1-5% of patients.
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