Henoch-Schönlein purpura

Description of Ligos
This is a systemic vasculitis (inflammation of small blood vessels) characterized by skin rash, bruising, abdominal pain, nausea, vomiting, gastrointestinal bleeding, joint inflammation, kidney damage. This vasculitis affects individuals up to 20 years old (not common in infants) who had an upper respiratory tract infection (tonsillitis, laryngitis, pharyngitis, etc.) a few weeks or months ago or were stung by insects. Vasculitis develops due to the excessive accumulation of immunoglobulin A, responsible for mucosal immune protection, in the blood and deposition in blood vessels. When blood vessels in the kidneys are affected, it can lead to inflammation (glomerulonephritis).

Symptoms
In children and adolescents, there is a sudden outbreak of skin on the legs, buttocks, less commonly on the trunk and arms, resembling multiple bruises (purpura) that do not change color when pressed. They may also have a slight fever, muscle and joint pain, abdominal pain, nausea, vomiting, sometimes with blood – this happens because bruises form not only on the skin but also in internal organs such as the stomach, intestines.

Diagnosis
Diagnosed based on existing symptoms, blood and urine tests. It is confirmed by a recent upper respiratory tract infection.
Inflammatory markers and globulin levels increase in the blood. In case of kidney damage, protein and blood cells are found in the urine. Sometimes, a skin or kidney tissue biopsy is performed for a more detailed examination.

Treatment
Bed rest is necessary, and it is important to drink plenty of fluids. If there is joint or muscle pain, nonsteroidal anti-inflammatory drugs are prescribed. In case of kidney damage, glucocorticosteroids are promptly administered to prevent kidney failure. If the cause and treatment of vasculitis are applied in a timely manner, this condition can be completely cured.

Source | Author Doctor Nikas Samuolis, reviewed by Prof. Virginijus Šapoka | Vilnius University | Faculty of Medicine | Head of the Department of Internal Medicine, Family Medicine, and Oncology