HSP (Henoch Schonlein Purpura)

Exam Cram

• HSP (Henoch Schonlein Purpura) is a form of IgA vasculitis

• Presentation: 

  • Purpura, athralgia, abdominal pain, haemoproteinuria

  • Recent infection 

• Diagnosis: clinical

• Management: none, can monitor BP/ proteinuria if persistent

Outline

Background

• Some books have renamed this is as IgA vasculitis and has similarities with IgA Nephropathy. Caused by IgA deposits

• Type of nephritic syndrome

Assessment

History

• Rash, abdo pain, arthalgia

• Recent URTI infection or gastroenteritis (classically Campylobacter), 

• Usually child, but can be adult

Examination

• Petechial rash/ palpable purpura

• Tender abdomen & polyarthropathy

• Systemically well

Investigations

• Urinanalysis: haemoproteinuria

• Normal Hb, platelets, creatinine & coag

• Renal biopsy: IgA deposits (not routinely required)

Diagnosis

Diagnostic criteria- clinical

Differentials- petechial rash associated with Thrombocytopenia, 

• Unwell: TTP/ DIC/ HUS

• IgA Nephropathy - wouldn't have a rash

Management

Nil management affects diseas course

Supportive care

1. Analgesia- NSAIDs or prednisolone

2. Can repeat BP & urinalysis in 2-4 weeks for resolution

Med Reg Notes

Renal Consult

If persistent HTN, haematoproteinuria, nephritic/ nephrotic syndrome can consult renal team for advice. 

References and Resources

1. https://www.rch.org.au/clinicalguide/guideline_index/HenochSchonlein_purpura/

Written 2024