Henoch-Schonlein Purpura in Children and Adults – Pictures, Symptoms, Causes

What is Henoch-Schonlein Purpura?

Henoch-Schonlein Purpura is also termed by the medical professionals as Purpura Rheumatica or Anaphylactoid Purpura. It is one of the diseases in the blood vessel that cause inflammation or purpura. The Henoch-Schonlein Purpura affects the capillaries in the skin and the kidney. It looks like a purple mark in the skin that looks like bruises that is normally seen in the buttocks and legs of the person and it’s associated with joint pain as well as abdominal pain

Image source – nlm.nih.gov

Signs and Symptoms

• The triad signs of Henoch-Schonlein Purpura : (1) purpura (2) joint swelling and pain (3) abdominal pain
• Typically seen in the legs and buttocks but it can seen in other parts of the body as well like arms, trunk, and face.
• Nausea and vomiting caused by the abdominal pain that is present in this disease.
• Patient may also experience constipation and diarrhea due to inflammation that is present in this disease that can cause an obstruction or changes in the bowel movement.
• Some people who have this disease will experience hematuria or there is a presence of blood in the urine as well as presence of blood in the stools
• Presence of rashes in the affected area.
• Patient will also experience fever due to the infection present.

Causes

This disease has no specific cause why it happened or how it began. Medical professionals think that there are (1) problem in the person’s immune response, in which the body of the individual treats its own blood vessels as somewhat as a trespasser and the immune response of the person attacks them or so called antibodies that attacks the trespasser and the abnormal presence of Immunoglobulin A in the affected blood vessels. It might be also associated to the (2) Presence of infection (3) Allergic reactions(4) Exposure to chemicals (5) Exposure to cold weather.

Diagnosis of Henoch-Schonlein Purpura

• Patient history
• Physical exam that the medical professional will see the rashes, lesions, and joint pain and joint stiffness.
• Urinalysis to check presence of blood.
• Skin biopsy is a minor operation where the medical professional will cut a small portion of the infected part to determine what cause it. It will help the medical professional to identify the disease that causes the inflammation.
• Presence of IgA or Immunoglobulin A is a specific antibody that is responsible in the body secretions like mucus and tears that is deposited in the walls of the blood vessels that is affected by the disease.
• Blood test to check presence of infection, and kidney problem.

Differential Diagnosis

This different diagnosis that is related somewhat in Henoch-Schonlein Purpura has a similar signs and symptoms. These disease are:

• Acute abdominal pain that is present in Henoch-Schonlein Purpura
• Presence of Acute hemorrhagic edema is a condition that is normally present in children that can cause purpuric kind of lesions that are visible in the body like in the face and extremities.
• Bacterial Endocarditis is a disease that will result the heart to became inflamed due to the bacteria that are present that might result of having a fever.
• Child abuse that will result in visible skin marks and lesions and trauma.
• Leukocytoclastic Vasculitis is a phenomenon where the immune system became altered and damage also the blood vessels that will result in the abrupt onset of rashes and it can lead also for the person to have fever.
• Inflammatory bowel disease like diarrhea that also result in possible weight loss, fever, and severe or mild abdominal pain.
• Rheumatoid arthritis that can cause a presence of rash in the person’s body but the rash in this disease is not palpable compare to Henoch-Schonlein Purpura.
• Kawasaki Disease is a kind of disease that will result in having a high fever and there are present of rashes in the body.
• Leukemia is a type of cancer in the blood that had symptoms of bleeding, body malaise, and pain in the bone.
• Meningococcemia is a type of disease in the respiratory tract that also has the presence of fever, skin rashes and body malaise.
• Thrombocytopenic Purpura a disease that also has the present of rashes in the body that is similar to Henoch-Schonlein Purpura.
• Rheumatic fever that can cause a presence of rash in the person’s body but the rash in this disease is not palpable compare to Henoch-Schonlein Purpura.
• IgA nephropathy can result in having rashes in the body, abdominal pain, and joint inflammation.
• Chicken Pox that will result in having skin rashes and lesion and the patient will also have a fever.

Treatment

There is no precise treatment for Henoch-Schonlein Purpura because this disease is known for being self-limiting type of disease that doesn’t need any treatment. The treatment focused only on the signs and symptoms that are present in the individual. These treatments main goal is to support the patient and prevent complications:

• Antibiotics to cure and prevent further infection.
• Anti-inflammation Drugs due to swelling of joints and joint inflammation.
• Corticosteroids for the treatment of abdominal pain and if there are present kidney disease.
• Adequate hydration to the patient especially if they experience diarrhea, nausea and vomiting.
• Close monitoring for possible renal and abdominal complications that might make the disease worse.

Complications

This disease is normally cured if the patient seeks immediate medical treatment by the medical professionals. This complication that is mentioned is due to the effect of not having an immediate treatment and some are due to the development of this disease that will affect person in long-term.

• Kidney Damage which can result in having a presence of blood in the urine, it can also lead in swelling and high blood pressure. If not treated early, there is a possibility that it will go further in “end-stage renal disease” that will cause a life time treatment. This disease normally occurs in adults than in children.
• Bowel obstruction due to inflamed blood vessels that will possibly blocked the passageway. It also will result in decrease blood flow to the area that will result in inflammation affecting different organs.
• For female who is affected by this disease when they where a child has a possibility to develop high blood pressure during pregnancy which are both dangerous to the baby and the mother.
• In some cases, some people will develop Myocardial Infarction that will have a disturbance in the blood supply in the heart that might lead in having a heart attack.
• Pulmonary Bleeding or hemorrhage is also possible complication of this disease.

Pictures

Picture 2 – Henoch-Schonlein Purpura on legs, buttocks and thighs

Image source – rch.org.au

Picture 4 – Henoch-Schonlein Purpura on legs (lateral view)

Image Source – bmj.com

Henoch-Schonlein Purpura in Children. Henoch-Schonlein Purpura is common in male children. There is no usual involvement in having renal disease

Henoch-Schonlein Purpura in Adults. Male is normally is affected by this disease. Renal involvement is high in adults. Progression in having a kidney failure is also greater in adults