Kids Health Info

Henoch-Schonlein Purpura HSP

  • What is Henoch-Schönlein Purpura (HSP)?

    Henoch-Schönlein Purpura causes blood vessels to become inflamed (irritated and swollen). This inflammation is called vasculitis. It usually affects the small blood vessels in the skin causing a rash that is called purpura. It can also affect blood vessels in the intestines and the kidneys.

    The cause of HSP is unknown. It might be triggered by a bacterial or viral infection, medicines, insect bites, vaccinations or exposure to chemicals or cold weather. It occurs most often in the spring, usually after an upper respiratory tract infection such as a cold.

    HSP usually affects children from two to 10 years of age, but it can happen in anyone. HSP itself is not contagious. Doctors don't know how to prevent HSP yet.

    Signs and symptons

    • Skin rash: The rash looks like small bruises or small reddish-purple spots. It's usually seen on the buttocks, on the legs and around the elbows.
    • Swelling: Many children with HSP also have swelling over the backs of the feet and hands and the scrotum in boys.
    • Pain in the joints: Such as the knees and ankles.
    • Stomach pain.
    • Blood in the stool (poo) or urine:  Caused by the blood vessels in the bowel and the kidneys becoming inflamed. Serious kidney problems don't happen very often, but they can occur.
    • In rare cases, an abnormal folding of the bowel called intussusception can occur. This causes a blockage in the intestines that may need surgery.

    Treatment

    There is no specific treatment for HSP. Medicines can help your child feel better or treat the infection that may have triggered HSP.

    Fortunately, HSP usually gets better without any treatment. Painkillers (e.g. paracetamol) or anti-inflammatory medicines (e.g. ibuprofen) can help relieve the joint pain. Your doctor may recommend a drug called prednisolone (cortisone). This can help people with severe stomach pains or very painful joints. It may also be helpful in preventing kidney problems.

    HSP usually gets better on its own without causing lasting problems. About half of people who have had HSP once will get it again. A few people will have kidney damage because of HSP. This may occur in the first week or so of illness, but there may be a delay of weeks or months before it appears.  Your child's doctor will want to test urine samples and blood pressure several times after the HSP goes away to check for kidney problems.  These checks should go on for at least six months and some doctors recommend a blood pressure and urine check every year for life.

    Key points to remember

    • HSP causes inflammation of the small blood vessels in the skin causing a rash.
    • HSP can also affect blood vessels around the kidneys and intestines.
    • HSP occurs most often in children from two to 10 years old.
    • The cause of HSP is unknown.
    • Paracetamol and anti-inflammatory drugs help painful joints and general discomfort. 
    • Prednisolone may be prescribed. 
    • Return to your doctor if there is increasing pain, swelling, blood in the stools (poo) or urine or if you are worried at all.
    • Long term follow-up involving urine tests and blood pressure checks are very important.

    When to come back

    Return to your doctor or the hospital if your child has increasing stomach pains or swelling, blood in the stools or urine, or if you are worried for any other reason.

     

    Developed by The Royal Children's Hospital General Medicine. Thank you to the parents who reviewed this fact sheet. First published: 2003. Reviewed: May 2011

We want your feedback!  

Please complete this short survey (takes 2 minutes) to help us further improve this resource, thank you. 


Disclaimer 
This information is intended to support, not replace, discussion with your doctor or healthcare professionals. The authors of these consumer health information handouts have made a considerable effort to ensure the information is accurate, up to date and easy to understand. The Royal Children's Hospital, Melbourne accepts no responsibility for any inaccuracies, information perceived as misleading, or the success of any treatment regimen detailed in these handouts. Information contained in the handouts is updated regularly and therefore you should always check you are referring to the most recent version of the handout. The onus is on you, the user, to ensure that you have downloaded the most up-to-date version of a consumer health information handout.