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February 10, 2012

Henoch-Schonlein Purpura (cont.)

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What is the treatment for HSP?

While HSP is generally a mild illness that resolves spontaneously, it can cause serious problems in the kidneys and bowels. The rash can be very prominent, especially on the lower extremities.

The treatment of HSP is directed toward the most significant area of involvement. Joint pain can be relieved by antiinflammatory medications such as aspirin or ibuprofen (Motrin). Some patients can require cortisone medications, such as prednisone or prednisolone, especially those with significant abdominal pain or kidney disease. With more severe kidney disease, involvement called glomerulonephritis or nephritis, cyclophosphamide (Cytoxan), azathioprine (Imuran), or mycophenolate mofetil (Cellcept) have been used to suppress the immune system. Infection, if present, can require antibiotics.

What is the prognosis for patients with HSP?

The prognosis for patients with HSP is generally excellent. Nearly all patients have no long-term problems. The kidney is the most serious organ involved when it is affected. Rarely, patients can have serious long-term kidney damage or an abnormal bowel folding called intussusception. Some patients have recurrences of symptoms, particularly skin rash, for months to a year after the onset of the illness.

Recent data show that HSP in adults is generally more severe than in children. Adults have more severe kidney involvement and can require more aggressive treatment. The ultimate outcome, however, is usually very good for both adults and children.

Henoch-Schonlein Purpura At A Glance
  • Henoch-Schonlein purpura is a particular form of blood vessel inflammation called vasculitis.
  • Henoch-Schonlein purpura frequently follows an infection of the throat or breathing passages, but it can be induced by certain medications.
  • Henoch-Schonlein purpura causes skin rash, pain in the abdomen, and joint inflammation (arthritis).
  • The treatment of Henoch-Schonlein purpura is directed toward the most significant area of involvement.
  • The prognosis for patients with Henoch-Schonlein purpura is generally excellent.

References:

Primer on the Rheumatic Diseases. Springer, edited by John H. Klippel, et al., 2008.

Kelley's Textbook of Rheumatology. W B Saunders Co, edited by Shaun Ruddy, et al., 2000.


Last Editorial Review: 3/4/2009


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