What’s Schonlein-Henoch purpura?

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Schonlein-Henoch purpura is an autoimmune response that causes inflammation of blood vessels. Symptoms include a purple rash, joint pain, and stomach cramps. Diagnosis is often based on symptoms, but a urine sample or rash biopsy may be taken. Treatment may involve anti-inflammatory medication or cortisone. Complications can occur, so patients should report all symptoms to their doctor.

Schonlein-Henoch purpura, sometimes known as Henoch-Schonlein purpura (HSP), is a form of vasculitis or inflammation of blood vessels that occurs as a result of an autoimmune response. Technically, this condition should be written Schönlein-Henoch purpura, but Dr. Johann Lukas Schönlein, who first described this condition in 1800, is often stripped of his diaeresis. This condition is more common in children and often resolves on its own without the need for treatment.

There are three telltale signs of Schonlein-Henoch purpura: a distinctive purple mottled rash on the lower extremities, joint pain usually concentrated in the knees and ankles, and stomach cramps. Because these symptoms rarely appear alongside any other disease, a doctor often diagnoses Schonlein-Henoch purpura based on these symptoms alone. Patients may also experience nausea, vomiting, and bloody diarrhea, and in some cases, kidney involvement occurs.

While Schonlein-Henoch purpura can often be diagnosed based on symptoms and a physical exam, sometimes a doctor can take a urine sample for analysis. The levels of various compounds in the urine can confirm the diagnosis and provide more information about what is happening inside the patient. If renal involvement is suspected, urinalysis may be important. A biopsy of the rash may also be done to confirm that the rash isn’t caused by anything other than Schonlein-Henoch purpura.

The cause of Schonlein-Henoch purpura is not fully understood. The condition most commonly emerges in people recovering from viral or bacterial infections in the gut and is thought to be the result of an overzealous immune system. When blood vessels become inflamed, they can leak, causing the purplish, blotchy rash. People can also experience more serious complications such as intestinal blockages.

Allergic purpura, as it’s also known, is sometimes just allowed to run its course. If a patient begins to develop complications, anti-inflammatory medications may be prescribed to treat the inflamed blood vessels. Some patients may also be given cortisone to reduce the strength of the immune system response. If complications appear, further steps can be taken to resolve them.

Patients who notice signs of Schonlein-Henoch purpura should call their doctors. The doctor may recommend a wait-and-see approach or may ask the patient to make an appointment to be seen for an exam. It is especially important to report all symptoms to the doctor, so that the doctor has a complete picture of what the patient is experiencing.

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