Henoch-Schonlein purpura (HSP)

What is Henoch-Schönlein purpura?

Henoch-Schönlein (HSP) purpura causes blood vessels to get 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 occurs most often after an upper respiratory infection, like a cold.

HSP occurs most often in children from 2 to 10 years of age, but it can occur in anyone. HSP itself is not contagious. Doctors don’t know how to prevent HSP yet.

What are the signs and symptoms?

• Skin rash – the rash looks like small bruises or small reddish-purple spots. It’s usually on the buttocks, on the legs and around the elbows. Many children with HSP also have swelling over the backs of the feet and hands, and the scrotum (ball-sack) in boys.
• Pain in the joints (such as the knees and ankles).
• Stomach pain.
• Blood in the stool (poo) or urine (pee), caused by the blood vessels in the bowel and the kidneys becoming inflamed. Serious kidney or bowel problems don’t happen very often, but they can occur.

What treatments are available?

There is no specific treatment for HSP, although some medicines can help with the symptoms. Fortunately, HSP usually gets better without any treatment.

Painkillers (such as paracetamol) can help with pain in the joints.

Usually, HSP gets better on its own and doesn’t cause lasting problems. On average, symptoms settle down within 4 to 6 weeks. About half of people who had HSP once will get it again.

A few people will have kidney damage because of HSP. Your doctor will want to check urine samples several times after the HSP goes away, to check for kidney problems.

When should you come back?

You will need to attend your GP after 1 week to give a sample of urine. They may arrange to see you again after that (at 4, 8 and 12 weeks).

Return to your GP or hospital if your child gets increasing stomach pains, very painful joint swellings, blood in the urine or if you are worried for any other reason.