Henoch–Schönlein purpura

Posted by e-Medical PPT
Henoch–Schönlein purpura is a disease of the skin and other organs that most commonly affects children.In the skin, the disease causes palpable purpura;often there are joint pains and abdominal pain. When there is kidney involvement there may be loss of small amounts of blood and protein in the urine,the kidney involvement proceeds to chronic kidney disease.HSP is often preceded by an infection, such as pharyngitis.
HSP a systemic vasculitis and is characterized by deposition of immune complexes containing the antibody IgA; the exact cause for this phenomenon is presently unknown.
Purpura, arthritis and abdominal pain are known as the classic triad of Henoch–Schönlein purpura.The purpura typically appear on the legs and buttocks, but may also be seen on the arms, face and trunk. The abdominal pain is colicky in character, and may be accompanied by nausea, vomiting, constipation or diarrhea. There may be blood or mucus in the stools.The joints involved tend to be the ankles, knees, and elbows but arthritis in the hands and feet is possible; the arthritis is non-erosive and hence causes no permanent deformity.Forty percent have evidence of kidney involvement, mainly in the form of hematuria , but only a quarter will have this in sufficient quantities to be noticeable without laboratory tests.
The diagnosis is based on the combination of the symptoms, as very few other diseases cause the same symptoms together. Blood tests may show elevated creatinine and urea levels (in kidney involvement), raised IgA levels (in about 50%[7]), and raised C-reactive protein (CRP) or erythrocyte sedimentation rate (ESR) results; none are specific for Henoch–Schönlein purpura.
Overall prognosis is good in most patients.In adults, kidney involvement progresses to end-stage renal disease (ESRD) more often.


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