Review Article

Henoch-Schönlein Purpura: A Review Article

Authors: Paul F. Roberts, MD, Thomas A. Waller, MD, Todd M. Brinker, MD, Izabela Z. Riffe, MD, Jerry W. Sayre, MD, Robert L. Bratton, MD

Abstract

Henoch-Schönlein purpura (HSP) is the most common vasculitis of childhood. Although HSP is typically a disease of children, adult cases have been described. HSP can affect multiple organs with a characteristic rash present in all patients. Most cases resolve with symptomatic treatment, but serious complications can occur such as renal failure. Primary care physicians should be well aware of the disease because the true incidence is probably underestimated.


Key Points


* Henoch-Schönlein purpura (HSP) is the most common vasculitis of childhood.


* HSP can affect multiple organs, with a rash present in all cases.


* Treatment of HSP is usually symptomatic, but serious complications can occur.


* The true incidence of HSP is probably underestimated.

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References

1. Matteson EL. Notes on the history of eponymic idiopathic vasculitis: the diseases of Henoch and Schönlein, Wegener, Churg and Strauss, Horton, Takayasu, Behçet and Kawasaki. Arthritis Care Res2000;13:237–245.
 
2. Ballinger S. Henoch-Schönlein purpura. Curr Opin Rheumatol 2003;15:591–594.
 
3. Mills JA, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 criteria for the classification of Henoch-Schönlein purpura. Arthritis Rheum 1990;33:1114–1121.
 
4. Davies PJ. Mozart's death: a rebuttal of Karhausen: further evidence for Schönlein-Henoch syndrome.J R Soc Med 1991;84:737–740.
 
5. Kubba AK, Young M. Wolfgang Amadeus Mozart: a case report. J R Coll Surg Edinb 1996;41:44–47.
 
6. Blanco R, Martinez-Taboada VM, Rodriguez-Valverde V, et al. Henoch-Schönlein purpura in adulthood and childhood: two different expressions of the same syndrome. Arthritis Rheum1997;40:859–864.
 
7. Gedalia A. Henoch-Schönlein purpura. Curr Rheumatol Rep 2004;6:195–202.
 
8. Agraharkar M, Gokhale S, Le L, et al. Cardiopulmonary manifestations of Henoch-Schönlein purpura.Am J Kidney Dis 2000;35:319–322.
 
9. Robson WL, Leung AK. Henoch-Schönlein purpura. Adv Pediatr 1994;41:163–194.
 
10. Szer IS. Henoch-Schönlein purpura. Curr Opin Rheumatol 1994;6:25–31.
 
11. Gardner-Medwin JM, Dolezalova P, Cummins C, et al. Incidence of Henoch-Schönlein purpura, Kawasaki disease, and rare vasculitides in children of different ethnic origins. Lancet 2002;360:1197–1202.
 
12. Saulsbury FT. Epidemiology of Henoch-Schönlein purpura. Cleveland Clin J Med 2002;69:SII-87–SII-9.
 
13. Fervenza FC. Henoch-Schönlein purpura nephritis. Int J Dermatol 2003;42:170–177.
 
14. Saulsbury FT. Henoch-Schönlein purpura. Curr Opin Rheumatol 2001;13:35–40.
 
15. Cotran RS, Kumar V, Collins T, editors. Robbins pathologic basis of disease, 6th ed. Philadelphia, Saunders, 1999.
 
16. Rostoker G. Schönlein-Henoch purpura in children and adults: diagnosis, pathophysiology and management. BioDrugs 2001;15:99–138.
 
17. Leung AK, Chan KW. Evaluating the child with purpura. Am Fam Physician. 2001;64:419–428. Erratum in: Am Fam Physician 2002;65:1751.
 
18. Saulsbury FT. Henoch-Schönlein purpura in children: report of 100 patients and review of the literature. Medicine (Baltimore) 1999;78:395–409.
 
19. Choong CK, Beasley SW. Intra-abdominal manifestations of Henoch-Schönlein purpura. J Paediatr Child Health 1998;34:405–409.
 
20. Halling SF, Soderberg MP, Berg UB. Henoch Schönlein nephritis: clinical findings related to renal function and morphology. Pediatr Nephrol 2005;20:46–51. Epub 2004 Oct 22.
 
21. Bailey M, Chapin W, Licht H, et al. The effects of vasculitis on the gastrointestinal tract and liver.Gastroenterol Clin North Am 1998;27:747–782.
 
22. Giangiacomo J, Tsai CC. Dermal and glomerular deposition of IgA in anaphylactoid purpura. Am J Dis Child 1977;131:981–983.
 
23. Kraft DM, Mckee D, Scott C. Henoch-Schönlein purpura: a review. Am Fam Physician 1998;58:405–408.