What is Henoch Schönlein purpura (HSP)?
Henoch Schönlein purpura is a disease which causes inflammation (irritation and swelling) and damage to small blood vessels called ‘capillaries’ producing a characteristic skin rash. It can also affect the joints, bowel and the kidneys.
It was named after the doctors who first described the disease. It is not an inherited disease and is not contagious.
What causes HSP?
The exact cause of HSP is unknown but it seems to follow some viral or bacterial infections such as a cold or respiratory tract infection.
It is most commonly seen in children aged two and 11 years old though can occur in younger or older children. It affects more boys than girls.
What symptoms will my child show?
HSP causes a skin rash, pain in the large joints (such as knees, ankles and wrists) and stomach pain. The rash is called ‘Purpura’ and will appear as small bruises or reddish-purple spots usually on buttocks, around the elbows and ankles.
HSP can also cause fever, nausea, vomiting, tummy aches and diarrhoea. If the blood vessels in the bowel and the kidneys get inflamed, it causes bloody stools or urine.
HSP can cause protein and blood in urine (usually detected on a dip stick urine test), but serious kidney problems are rare. Often this finding will resolve as your child improves, but very occasionally it can be a serious long term problem. This is why your child will need careful monitoring after discharge from hospital.
In rare cases, an abnormal folding of the bowel called intussusception can occur and child may need surgery.
How is it diagnosed?
HSP is usually diagnosed by looking at your child’s history of symptoms and with a physical examination. They will often need a blood test and urine test.
If there is a lot of blood and protein in the urine, very high blood pressure, or other blood test markers of kidney damage, further tests will be required. This is rarely needed, however.
How is it treated?
There is no specific treatment for HSP other than rest and recuperation, and symptoms usually go away within several weeks. Infant paracetamol, such as Calpol, or ibuprofen can be given to relieve any joint pains.
Steroids may be used in children with severe symptoms, particularly bad tummy pain or kidney damage.
Will there be long term effects in my child?
Overall, most children make a full recovery, although relapses (usually milder than the first attack) can occur in about half of the children in the following months.
Once the rash and joint pains have settled, the GP may want to continue to check urine samples for several months to check for kidney problems. Be sure to follow up with the GP as advised.
Children with kidney involvement require regular follow up to monitor the urine and blood pressure and may need further investigations if evidence of persistent damage to the kidneys.
If you have any questions or concerns, contact
Paediatric Assessment Unit (9am-9pm)
Telephone: 01935 384 788
Children’s Ward (9pm-9am)
Telephone: 01935 384 360
If you need this information in another format, eg. a different language, please ask a member of staff.
