2. BACKGROUND
1st described in 1801 by William Heberden, a
physician in london, who wrote about a case of
a 5 year old boy with hematuria, abdominal
pain, joint pains and skin rash.
3. EPIDEMIOLOGY
HSP (IgAV) is a systemic vasculitic syndrome
seen primarily in children.
Male –to- female ratio: 1.8: 1
8. Arthralgia/ arthritis:
2nd most common presentation 84%
Usually transient or migratory
Oligoarticular
Nondeforming
Lower extremity large joints
9. Abdominal Pain:
50% of patients complain of colicky pain
typically develop within 8 days of the
appearance of rash.
GI bleeding in 20 – 30 %
Inussusception is a common complication in
children.
10. Renal disease:
Ranges from 21-54 %
Hematuria with or without red cell cast.
Proteinuria ranges from mild to nephrotic range.
Elevated creatinine and/ or HTN.
13. Renal biopsy is reserved
for patients in whom the
diagnosis is uncertain or
evidence of sever renal
impairment
Skin biopsy including
small blood vessels of
superficial dermis
15. Management
Admission is warranted for the following:
• Sever abdominal pain
• GI bleeding
• Elevated creatinine, HTN, and/ or nephrotic
• Sever joint involvement
• Changes in mental status
18. Glucocorticoids
• Their use in patients with HSP is controversial
• Prednisone 1- 2 mg /kg daily (max 80 mg)
• To be used only in patients with symptoms
sever enough to affect oral intake or daily
activities.
19. Disease modifying agents:
• Targeted toward preventing or ameliorating GI
and renal complications.
• Limited data suggest that cyclophosphamide
and cyclosporine may be beneficial.
• Plasmapharesis has been used in patients with
crescentic disease and rapidly progressive
renal failure.
