Henoch-Schonlein Purpura – Symptoms and Causes
Overview
IgA vasculitis (formerly called Henoch-Schonlein purpura) is a condition where small blood vessels become inflamed and leak. This inflammation affects vessels in the skin, joints, intestines, and kidneys.
The most noticeable symptom is a distinctive reddish-purple rash that typically appears on the buttocks and lower legs. This rash occurs when blood vessels bleed into the skin. Besides the rash, people with this condition often experience:
- Joint pain and swelling
- Stomach pain
- Possible kidney problems in severe cases
This condition is most common in children under 10 years old, though it can affect people of any age. Most cases get better without treatment, but medical care becomes necessary if the kidneys are affected.
Patients with IgA vasculitis may need various healthcare services depending on symptom severity. These typically include:
- Physical examinations to monitor the rash and other symptoms
- Blood and urine tests to check kidney function
- Pain management for joint discomfort
- Dietary guidance for digestive symptoms
- Kidney monitoring for those with more serious cases
Most patients recover completely within several weeks, though some may experience recurring episodes.
Signs and Symptoms
Henoch-Schonlein purpura has four main features that doctors look for when making a diagnosis:
Skin Rash
Purple-red spots that resemble bruises typically appear on the legs, buttocks, and feet. These spots may spread to the arms, face, and trunk.
The rash often worsens in areas where clothing puts pressure on the skin, like waistbands and sock lines.
Joint Problems
Many patients experience:
- Pain and swelling in joints
- Most commonly affects knees and ankles
- Joint pain may appear 1-2 weeks before the rash
- Symptoms disappear as the illness resolves without causing permanent damage
Digestive Issues
Stomach and intestinal symptoms include:
- Abdominal pain
- Nausea and vomiting
- Blood in stool
- May occur before the rash appears
Kidney Involvement
The condition can affect kidney function in these ways:
- Blood or protein in urine (often detected only through testing)
- Usually temporary and resolves when the illness ends
- In some cases, it may lead to ongoing kidney problems
When to Get Medical Help
Contact your healthcare provider immediately if you notice the distinctive purple-red rash on your child’s skin. Prompt medical evaluation is important for proper diagnosis and care.
Seek medical attention right away if you or your child has Henoch-Schonlein purpura and experiences serious digestive problems like severe abdominal pain or bloody stools.
Causes
The exact trigger of Henoch-Schonlein purpura is not fully understood. The condition happens when small blood vessels become inflamed, leading to bleeding in the skin, abdomen, and kidneys.
This inflammation likely results from an abnormal immune system response to certain triggers.
About half of all cases develop after upper respiratory infections like colds. Other possible triggers include:
- Viral infections (chickenpox, measles)
- Bacterial infections (strep throat)
- Hepatitis
- Certain medications
- Food allergies or sensitivities
- Insect bites
- Exposure to cold weather
These triggers may cause the immune system to react in ways that harm the body’s own tissues, particularly blood vessels.
Risk Factors
Several factors may increase the chance of developing Henoch-Schonlein purpura:
- Age: Children under 10 years old are most commonly affected.
- Gender: Boys have a slightly higher risk than girls.
- Ethnicity: White and Asian children develop this condition more frequently than Black children.
These risk factors help doctors identify who might be more likely to develop this condition, though it can affect anyone.
Possible Problems
Most people get better within a month without lasting issues. However, the condition can come back in some cases.
Some serious complications may include:
Kidney Damage: This is the most concerning problem, especially for adults. In severe cases, patients might need dialysis or a kidney transplant.
Intestinal Blockage: In rare situations, a part of the bowel can fold into itself (like a telescope). This blocks the normal movement of food and waste through the digestive system.
If symptoms persist or worsen, contact a healthcare provider immediately.
