Schonlein-Henoch purpura, sometimes known as Henoch-Schonlein purpura (HSP), is a form of vasculitis or blood vessel inflammation which occurs as a result of an autoimmune response. Technically, this condition should be spelled Schönlein-Henoch purpura, but Dr. Johann Lukas Schönlein, who first described this condition in the 1800s, is often deprived of his umlaut. This condition is most commonly seen in children, and it often resolves on its own without the need for treatment.
There are three tell-tale signs of Schonlein-Henoch purpura: a distinctive purple spotted rash on the lower limbs, joint pain which usually centers in the knees and ankles, and stomach cramping. Since these symptoms rarely appear together in association with any other illness, a doctor will often diagnose Schonlein-Henoch purpura on the basis of these symptoms alone. Patients can also experience nausea, vomiting, and bloody diarrhea, and in some cases, kidney involvement occurs.
While Schonlein-Henoch purpura can often be diagnosed on the basis of the symptoms and a physical exam, sometimes a doctor may take a urine sample for analysis. The levels of various compounds in the urine may confirm the diagnosis and provide additional information about what is going on inside the patient. If kidney involvement is suspected, urinalysis can be important. A biopsy of the rash can also be taken to confirm that the rash is not being caused by something other than Schonlein-Henoch purpura.
The cause of Schonlein-Henoch purpura is not fully understood. The condition most commonly emerges in people who are recovering from viral or bacterial infections in the gut, and it is believed to be the result of an overzealous immune system. As the blood vessels become inflamed, they can leak, resulting in the blotchy purple rash. People can also experience more serious complications such as bowel obstructions.
Allergic purpura, as it is also known, is sometimes simply allowed to run its course. If a patient starts to develop complications, antiinflammatory medications can be prescribed to treat the inflamed blood vessels. Some patients may also be given cortisone to reduce the intensity of the immune system's response. If complications appear, additional steps can be taken to address them.
Patients who notice the signs of Schonlein-Henoch purpura should call their doctors. The doctor may recommend taking a wait and see approach, or may ask the patient to make an appointment to be seen for an examination. It is especially important to report all symptoms to the doctor, so that the doctor has a complete picture of what the patient is experiencing.
