Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Dr. Lee was born in Shanghai, China, and received his college and medical training in the United States. He is fluent in English and three Chinese dialects. He graduated with chemistry departmental honors from Harvey Mudd College. He was appointed president of AOA society at UCLA School of Medicine. He underwent internal medicine residency and gastroenterology fellowship training at Cedars Sinai Medical Center.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Featured patient discussions on Henoch-Schonlein purpura
"I was diagnosed with Henoch-Schonlein purpura when I was 18, so about six years ago now. It was in the autumn months, which is when it is more prevalent. I initially suffered from a viral infection. Later that week, I developed pains in my abdominal area, and then came down with the meningitis-like rash. I was in the hospital for three weeks. All the symptoms described, I have had. However, I am or was one of the few who got renal failure as a result. It is believed to be chronic and not end stage. However, I am on continuing medication as a result. The thing I have found as a result of my diagnosis, is that I can't eat spicy food or red meat. My metabolism has slowed to a point that I am more prone to putting on weight than I used to be. This is one of those diseases that puzzle even the most genius of specialists. Bar the diet, I still get to live a relatively normal life."
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What is Henoch-Schonlein purpura (HSP)?
Henoch-Schonlein purpura (HSP)
is a form of blood vessel inflammation or vasculitis. There are many different conditions that feature vasculitis. Each of the forms of vasculitis tends to involve certain characteristic blood vessels. HSP affects the small vessels called capillaries
in the skin and frequently the kidneys. HSP results in skin rash
(most prominent over the buttocks and behind the lower extremities)
associated with joint inflammation (arthritis) and sometimes cramping pain
in the abdomen. Henoch-Schonlein purpura is also referred to as anaphylactoid purpura.
What causes HSP?
HSP occurs most often in the spring and frequently
follows an infection of the throat or breathing passages. HSP
seems to represent an unusual reaction of the body's immune system
that is in response to this infection (either bacteria or virus). Aside from infection, drugs can also trigger the condition.
HSP occurs most commonly in children, but people of all age groups
can be affected.
What are symptoms of HSP?
Classically, HSP causes skin rash, pain in the abdomen,
and joint inflammation (arthritis). Not all features need be present for the diagnosis. The rash of skin lesions appears in gravity-dependent areas, such as the legs. The joints
most frequently affected with pain and swelling are the ankles and the knees. Patients with HSP can develop fever. Inflammation
of the blood vessels in the kidneys can cause blood and/or protein
in the urine. Serious kidney complications are infrequent but
can occur.
Symptoms usually last approximately a month. Recurrences are not frequent but do occur.
How is HSP diagnosed?
HSP is usually diagnosed based on the typical skin, joint, and kidney findings. Throat culture, urinalysis,
and blood tests for inflammation and kidney function are used to suggest the diagnosis. A
biopsy of the skin, and less commonly kidneys, can be used to demonstrate vasculitis. Special staining techniques (direct immunofluorescence) of the biopsy specimen can be used to document antibody deposits of IgA in the blood vessels of involved tissue.
The word "rash" means an outbreak of red bumps on the body. The way people use this term, "a rash" can refer to many different skin conditions. The most common of these are scaly patches of skin and red, itchy bumps or patches all over the place.
Arthritis is inflammation of one or more joints. When joints are inflamed they can develop stiffness, warmth, swelling, redness and pain. There are over 100 types of
arthritis including osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, lupus, gout,
and pseudogout.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Vasculitis is a general term for a group of uncommon diseases which feature inflammation of the blood vessels. Each form of vasculitis has its own characteristic pattern of symptoms. The diagnosis of vasculitis is definitively established after a biopsy of involved tissue demonstrates the pattern of blood vessel inflammation. Treatment is directed toward decreasing the inflammation of the arteries and improving the function of affected organs.
A urinalysis is simply an analysis of the urine. It is a very common test that can be performed in many healthcare settings including doctors' offices, urgent care facilities, laboratories, and hospitals.
It is performed by collecting a urine sample from the patient in a specimen cup.
Usually only small amounts (30-60 ml's) may be required for urinalysis testing.
The sample can be either analyzed in the medical clinic or sent to a laboratory
to perform the tests. Urinalysis is abbreviated UA.
Urine can be evaluated by its physical appearance (color, cloudiness, odor,
clarity), or macroscopic analysis. It can be also analyzed based on its chemical
and molecular properties or microscopic assessment.
Urinalysis is ordered by doctors for a number of reasons, as follows:
Routine medical evaluation: general yearly screening, assessment before
surgery (pre-operative assessment), admission to h...
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