Have you been scared when your little one suddenly develops small red-purple spots on their legs and buttocks? They may have complained of stomach aches and joint pain. It's normal for any parent to be concerned when they see something like this. But most of the time, it's not serious . These symptoms could be caused by a condition called Henoch-Schönlein Purpura (HSP), or as it's now being called, IgA Vasculitis. Let's talk about it simply.
Simply put, what is Henoch-Schönlein Purpura (HSP)?
Henoch-Schönlein Purpura (HSP) is, medically speaking, a type of ``Vasculitis.`` Vasculitis is when the blood vessels in our body, which are like small tubes that carry blood, become inflamed from the inside. Just like when our skin swells when it gets injured, there is swelling inside the blood vessels.
In HSP, this swelling mainly occurs in the very fine, small blood vessels under the skin. However, sometimes this effect can also extend to the blood vessels in the kidneys, intestines, and joints.
This happens because a special protein (antibody) called `(Immunoglobulin A)` or `(IgA)`, which is part of our body's immune system (that is, the system that protects us from diseases), accumulates in the blood vessels. When `(IgA)` accumulates in this way, the blood vessels are damaged, they burst, and a small amount of blood leaks under the skin. That's why we see purple and red spots on the outside. Like a small bruise.
This condition is also called `(IgA) Vasculitis` because the `(IgA)` antibody is involved. Although it can develop in people of any age, it is most commonly seen in children .
The important thing is that HSP is not usually a serious condition. Most children recover completely without treatment. However, it can be more severe in adults.
What symptoms do we see?
The symptoms of HSP can mainly affect the child's skin, joints, intestines, and kidneys. The most prominent and obvious symptom is the purple-red spots that appear on the skin. Let's look at these symptoms separately.
| Symptom | Description |
|---|---|
| Skin rash | This is the main symptom. It causes red or purple spots that are slightly raised on the surface of the skin. Sometimes there are just a few spots, sometimes there can be many. These are usually not itchy or painful . They are most often seen on the child's legs and buttocks . |
| Joint pain and swelling | Joints, especially the knees and ankles, become swollen and painful. The child may also have difficulty walking. |
| Stomach ache | Stomach cramps may come and go. Some children may also experience vomiting and nausea. |
| Other features | Very rarely, blood in the stool or blood in the urine (red/brown urine) may be seen. These may be signs of kidney or intestinal problems. |
Why does this happen? What are the reasons?
HSP is an autoimmune disease. Simply put, our body's "army" (the immune system) mistakenly starts attacking its own healthy blood vessels. Researchers still don't know exactly why this happens.
But one thing is clear: About 50% of children who develop HSP have had an upper respiratory infection, such as a sore throat or a cold, a few days before these symptoms appear .
Other things that can trigger HSP (Triggers)
Sometimes, HSP can also occur as an abnormal response of the immune system to the following:
- Bacterial infections, for example strep throat.
- Viral infections.
- Some foods.
- Insect bites.
- Some medications.
- Some types of vaccines (this is very rare).
Who is most likely to develop this condition?
Although IgA vasculitis can occur at any age, more than 90% of cases are reported in children between the ages of 3 and 10 .
Other risk factors are:
- Family history: If someone in your family has had HSP, your child is at slightly higher risk of developing it too.
- Genetic influence: This condition has been found to be quite common among people of European and Asian descent.
Are there any complications that can occur due to HSP?
Most people recover completely within a month or three without any treatment. Sometimes the disease can recur, but that too often resolves on its own.
However, rarely, especially among adults, HSP can become serious and cause complications.
- Kidney damage: Long-term kidney disease can occur. This is the main complication to watch out for in HSP.
- Bleeding in the intestines.
- Damage or blockage of the intestines.
- High blood pressure during pregnancy (for women).
How do you find this, Doctor?
When you take your child to a pediatrician, he or she will first examine your child carefully, especially looking for any skin rashes and swollen joints. Then, they will ask you about your child's symptoms and any recent illnesses.
To confirm the diagnosis and rule out other medical conditions, the doctor may order some tests.
- Urinalysis: To determine if the kidneys have been affected, the urine is checked for blood or protein.
- Blood test: To check for infection or other problems in the body.
- Kidney ultrasound: Check the condition of the kidneys.
- Abdominal ultrasound: Find out the cause of stomach pain.
- Skin biopsy: In some cases, a very small piece of skin is taken from the area where the mole is and examined to confirm the diagnosis.
- Kidney biopsy: A test that is only done if there is suspicion of serious kidney damage.
What are the treatments for HSP?
Most of the time, HSP does not require specific treatment. The main thing is to manage the symptoms at home.
For joint pain and swelling, you can take paracetamol (Tylenol®) or an NSAID pain reliever (Advil®) as directed by your doctor.
However, if symptoms such as stomach aches are severe, the doctor may prescribe a steroid medication such as prednisone. If the skin rash and other symptoms persist, be sure to see your child's doctor.
Remember, HSP is often a mild condition that resolves on its own. But rarely, it can cause serious complications, including kidney and intestinal problems. Therefore, some children may need to take medications to keep their immune systems working properly. Talk to your doctor about these medications and their side effects.
When should we see a doctor?
It is best to see a doctor as soon as your child has these symptoms. Also, if the following symptoms appear during treatment or while the disease is healing, see your doctor again.
| When to seek immediate medical advice | |
|---|---|
| 1. | If there is unusual swelling. |
| 2. | If the child is in unbearable pain or discomfort. |
| 3. | If symptoms last more than 12 weeks. |
| 4. | If the symptoms improve and then reappear. |
| 5. | If the symptoms are getting worse day by day, instead of getting better. |
HSP is not a lifelong condition. It usually resolves within a month or three. Some children can have a second episode, but the symptoms are usually less severe.
Finally, HSP can cause your child pain and discomfort. It can be very difficult for parents to see their child in pain. But remember, most children recover completely without any long-term complications . The doctor may want to follow up with your child for a period of time to check the condition of their kidneys. This is very important.
Take-Home Message
- Henoch-Schönlein Purpura (HSP) is a condition in which small blood vessels under the skin swell, causing purple-red spots on the legs and buttocks.
- This is most commonly seen in children and is usually not a serious condition.
- Symptoms such as joint pain and stomach ache may also occur with this.
- Most children recover completely within 1-3 months without special treatment.
- It is very important to see a doctor immediately if you notice these spots on your child's skin, as they can rarely affect the kidneys.
- It is essential to follow the doctor's instructions and undergo regular checkups.
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