Henoch–Schönlein purpura is a form of systemic vasculitis that most often affects children. It involves inflammation of small blood vessels and typically appears after a common infection such as a cold or sore throat. What draws attention first is usually the skin. Purplish spots that resemble bruises suddenly appear, most often on the legs or buttocks. Unlike ordinary bruises, these spots can be felt when touched.
As the condition progresses, other parts of the body may become involved. Abdominal pain is common and can range from mild discomfort to severe cramping. Some children develop bloody stools as a result of intestinal involvement. Joint pain or swelling, especially in the knees or ankles, may also occur. In a smaller number of cases, the kidneys are affected, leading to blood or protein in the urine.
Most children recover fully over time, but the course can vary. Skin symptoms often improve on their own, while abdominal or kidney involvement may require closer monitoring. Because kidney complications can develop later, even after the rash fades, follow-up is an important part of care.
Henoch Schonlein Purpura Quick Overview
| Category | Key points |
|---|---|
| Main cause | Abnormal immune response |
| Common signs | Palpable purpura, abdominal pain, joint pain |
| Diagnosis focus | Characteristic rash with clinical symptoms |
| Treatment approach | Supportive care, medication in severe cases |
| Warning signs | Bloody stool, blood or protein in urine |
Henoch–Schönlein purpura differs from simple bruising because the rash is raised and often accompanied by systemic symptoms.
Causes
| Factor | Description |
|---|---|
| Immune reaction | Often follows respiratory infection |
| Small vessel inflammation | Affects skin, gut, joints, kidneys |
| Triggering infections | Colds or viral illnesses |
| Unknown predisposition | Exact cause not fully defined |
The condition reflects an immune-mediated process rather than an infection itself, which is why it is not contagious.
Key Symptoms
| Severity | Typical features | When noticed |
|---|---|---|
| Mild | Leg purpura, mild joint pain | Early stage |
| Moderate | Abdominal pain, joint swelling | As disease progresses |
| Severe | Bloody stool, kidney findings | Requires prompt evaluation |
Symptoms often begin in the lower body and may spread upward. Gravity-related areas are commonly affected.
Diagnosis Focus
| Method | What is assessed | Notes |
|---|---|---|
| Physical exam | Distribution and texture of rash | Core diagnostic feature |
| Urine test | Blood or protein | Repeated monitoring needed |
| Blood tests | Inflammation, kidney function | Supportive |
| Biopsy | Atypical cases | Selective use |
While the rash pattern is often diagnostic, urine testing is essential to identify kidney involvement early.
Treatment Direction
| Approach | Purpose | Considerations |
|---|---|---|
| Rest and observation | Symptom relief | Many cases resolve |
| Pain relief | Joint and abdominal pain | Use cautiously |
| Corticosteroids | Severe abdominal or joint symptoms | Medical supervision |
| Immunosuppressive therapy | Significant kidney disease | Specialist care |
Skin findings alone usually improve without aggressive treatment. Therapy is guided mainly by abdominal and kidney symptoms.
Warning Signs
| Potential complication | What to watch for | Action |
|---|---|---|
| Kidney inflammation | Blood or protein in urine | Regular follow-up |
| Nephrotic syndrome | Swelling of face or limbs | Urgent evaluation |
| Chronic kidney disease | Reduced urine output | Long-term monitoring |
Although most children recover well, kidney involvement requires continued observation even after other symptoms resolve.
FAQ
Is Henoch–Schönlein purpura contagious?
No. It is related to immune system activity, not infection spread.
How is it different from a normal bruise?
The rash is raised and can be felt when pressed, unlike flat bruises.
Is severe abdominal pain dangerous?
It can indicate intestinal bleeding or complications and should be evaluated.
Are steroids always needed?
No. They are usually reserved for significant abdominal or joint symptoms.
Can the condition come back?
Recurrence can happen in some children, so monitoring is important.
Is full recovery possible?
Most children recover completely, especially when kidney involvement is absent.
Real-Life Experience Example
Some parents describe noticing purple spots on their child’s legs shortly after a cold. At first, the marks look like bruises from play. When abdominal pain begins and the rash spreads, medical evaluation follows. With rest and supportive care, the rash and pain gradually improve. Continued urine checks over the following months help confirm that the kidneys remain healthy. These situations often show how early recognition can prevent unnecessary worry and complications.
References
- Mayo Clinic – Henoch–Schönlein Purpura
https://www.mayoclinic.org/diseases-conditions/henoch-schonlein-purpura - NHS – Henoch–Schönlein Purpura
https://www.nhs.uk/conditions/henoch-schonlein-purpura - National Kidney Foundation – HSP
https://www.kidney.org/atoz/content/henoch - NCBI Bookshelf – Henoch–Schönlein Purpura
https://www.ncbi.nlm.nih.gov/books/NBK441888 - UpToDate – Henoch–Schönlein Purpura
https://www.uptodate.com/contents/henoch-schonlein-purpura
Henoch–Schönlein purpura is often self-limited, but it should never be dismissed as simple bruising when abdominal pain, bloody stool, or urinary changes are present. Early evaluation and appropriate follow-up help ensure a safe recovery and reduce the risk of long-term complications.