A Family Doctor's Tale - HENOCH-SCHONLEIN PURPURA

DOC I HAVE HENOCH-SCHONLEIN PURPURA

Henoch-Schonlein Purpura is a bleeding disease where small blood vessels become fragile and allow blood to leak from them.

Bleeding into the skin give rise to a typical rash called purpura like a bruise while bleeding into the joints, kidneys or digestive tract can cause damage to these organs.

People of all ages are affected .

It is more common in children between the age of 2 to 10 years.

The cause is unknown but believed to be an allergic reaction to something or a bacterial infection (suspected streptococcus)

Symptoms of Henoch-Schonlein Purpura are:
1.rash is pink, red or purplish blood filled spots that do not fade
when pressed

2.the rash appears first on the buttocks and the back of arms and body especially around the ankles and elbows then spread to the front of the limbs.

3.joint pain and swelling

4.abdominal pain in many cases with vomiting and diarrhea

5.blood in the stools or urine

Diagnosis of Henoch-Schonlein Purpura is by:
1.The typical rash and its location can suggest the diagnosis of Henoch-Schonlein Purpura

2.Blood and urine tests may be done to rule out other causes and to exclude any kidney inflammation.

Blood and protein in the urine may suggest kidney involvement.

3.Abdominal X-ray may be needed if there is abdominal pain and vomiting

4.Ultrasound of kidney may also be needed for exclusion of serious kidney involvement.

Complications of Henoch-Schonlein Purpura are:
1.inflammation of the kidneys

2.joint arthritis due to bleeding in the joint

Treatment of Henoch-Schonlein Purpura:
No treatment may be needed if the condition or symptoms are mild.

For moderate or severe cases:
1. Bed rest is important

2. paracetamol for pain or fever

3. corticosteroids are needed as treatment for allergy

4. antibiotics are given if there is a bacterial infection.

Prognosis of Henoch-Schonlein Purpura is:
The illness may last a few days to a month during which the symptoms may recur.

Most patients make a full recovery and there is no long term ill effects.

In most cases inflammation of the kidneys disappears in a few days but in some patient recovery from the kidney inflammation may take up to 2 years.