Henoch-Schonlein purpura (HSP) is an IgA mediated small vessel vasculitis. There is a degree of overlap with IgA nephropathy (Berger's disease). HSP is usually seen in children following an infection.

Features

• palpable purpuric rash (with localized oedema) over buttocks and extensor surfaces of arms and legs
• abdominal pain
• polyarthritis
• features of IgA nephropathy may occur e.g. haematuria, renal failure

Treatment

• analgesia for arthralgia
• treatment of nephropathy is generally supportive. There is inconsistent evidence for the use of steroids and immunosuppressants

Prognosis

• usually excellent, HSP is a self-limiting condition, especially in children without renal involvement
• blood pressure and urinanalysis should be monitored to detect progressive renal involvement
• around 1/3rd of patients have a relapse

more common in children

GIT -  colicky pain (due to local vasculitis), bleeding, intussusceptions

Skin -  palpable purpura distributed symmetrically over the lower legs, buttocks, and arms

Joint-  arthralgia, most commonly affect the knees and ankles