Clinical practice Diagnosis and management of Henoch–Schönlein purpura

• Published in: European journal of pediatrics Vol. 169; no. 6; pp. 643 - 650
• Main Authors: McCarthy, Hugh J., Tizard, E. Jane
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer-Verlag 01.06.2010; Springer; Springer Nature B.V
• Subjects: Abdomen; Biological and medical sciences; Child; Clinical medicine; Dermatology; General aspects; Glomerulonephritis; Glomerulonephritis - drug therapy; Glomerulonephritis - etiology; Glomerulonephritis - pathology; Glucocorticoids - therapeutic use; Hematuria; Hemorrhage; Humans; Intestinal obstruction; Intussusception - drug therapy; Intussusception - etiology; Intussusception - pathology; Medical sciences; Medicine; Medicine & Public Health; Nephrology. Urinary tract diseases; Nephropathies. Renovascular diseases. Renal failure; Pain; Pathogenesis; Pediatrics; Prognosis; Purpura; Purpura, Schoenlein-Henoch - complications; Purpura, Schoenlein-Henoch - diagnosis; Purpura, Schoenlein-Henoch - drug therapy; Purpura, Schoenlein-Henoch - therapy; Review; Rheumatology; Vascular disorders of the skin; Glomerulonephritis; IgA; Corticosteroids; Treatment; Purpura; Intussusception; Kidney disease; Corticosteroid; Pediatrics; Skin disease; Urinary system disease; Diseases of the osteoarticular system; Cardiovascular disease; Vascular disease; Clinical management; Professional practice; Henoch-Schönlein purpura; Capillary vessel disease; Diagnosis
• ISSN: 0340-6199; 1432-1076
• DOI: 10.1007/s00431-009-1101-2

Henoch–Schönlein purpura (HSP) is the most common vasculitis of childhood. In this review, the main clinical features and complications are described. Although most features are self-limiting, renal disease is the most likely to result in long-term morbidity. Treatment of HSP nephritis is controversial, and the evidence for both prevention and treatment of established disease is reviewed. Follow-up for children presenting with HSP should be for at least 6 months and should include regular urine testing for proteinuria and haematuria and a blood pressure measurement. Women with a history of HSP during childhood are at increased risk of complications (such as proteinuria and hypertension) during pregnancy and should be monitored closely. This paper describes current practice with regard to investigation and management and proposes a practical care pathway of the management of a child with HSP.