(Anaphylactoid Purpura; HSP; Vascular Purpura)
Henoch-Schonlein purpura (HSP) is inflammation of the blood vessels in the skin and other organs. Sometimes it leads to a rash. Rarely, it can affect the kidneys.
HSP is caused by an abnormal reaction of the immune system. It attacks healthy blood vessels. It is not clear why this happens.
The change in the immune system may be triggered by:
- Bacterial or viral infections—some can be related to an insect bite
- Certain medicines
- Recent exposure to certain vaccines
HSP is most common in children less than 10 years old. The risk of HSP is higher in people who have had:
- An upper respiratory infection
- Exposure to vaccines, chemicals, cold weather, or insect bites
Symptoms may last for 4 to 6 weeks and may include:
- Reddish-purple raised spots on the buttocks, legs, or elbows
- Bruising that often happens below the waist
- Pain in the joints—usually the knees and ankles
- Belly pain or vomiting
- Blood in the urine (pee) or stool (poop)
- Swelling of the ankles
- Swelling of the scrotum in males
The doctor will ask about symptoms and past health. A physical exam may be done.
Tests may be done to look for problems. They may include:
- Blood tests
- Urine tests
- Stool sample
- Biopsy of the skin or kidney—a small tissue sample is taken and tested
No single test can diagnose HSP. Diagnosis is based on symptoms, tests, and ruling out other problems.
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HSP usually gets better on its own. Treatment includes rest, nutrition, and fluids. Medicines may be used to:
- Ease joint swelling and pain
- Treat bacterial infections
- Change how the immune system works
There are no known guidelines to prevent HSP.
- Henoch-Schonlein purpura. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/henoch-schonlein-purpura.
- Henoch-Schonlein purpura. Family Doctor—American Academy of Family Physicians website. Available at: https://familydoctor.org/condition/henoch-schonlein-purpura.
- Henoch-Schonlein purpura. GARD—Genetic and Rare Diseases Information Center website. Available at: https://rarediseases.info.nih.gov/diseases/8204/henochschonlein-purpura.
- Hetland LE, Susrud KS, et al. Henoch-Schonlein purpura: a literature review. Acta Derm Venereol. 2017;97(10):1160-1166.
- Daniel A. Ostrovsky, MD
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