Henoch Scholein Purpura

It is the most common primary systemic vasculitis in children. Diagnosis requires the presence of purpura or petechiae with lower limb predominance with one of the following four- 

  1. Abdominal pain 
  2. Arthritis or Arthralgia 
  3. Renal involvement(proteinuria or haematuria or presence of red blood cell casts) 
  4. Histopathology showing typical leukocytoclastic vasculitis with predominant IgA deposits. 

Complications include orchitis, intussusceptions and intestinal perforation. It is generally a self limiting illness, however, recurrence is seen in one-third of patients. Recurrence generally occurs  within four  months of resolution of the original symptoms. Renal involvement is the most serious long-term complication and can occur upto 6 months from the presentation. This can be easily picked up by a regular urine  examination every 15 days for presence of proteinuria and  RBCs.

Prednisolone (1 mg/kg per day for 2 weeks, with weaning over the subsequent 2 weeks) is effective in reducing the intensity of abdominal pain and joint pains. It does not prevent the development of renal complications, however, it is used in treating them.

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