Henoch Purpura

Henoch purpura

        Rheumatoid purpura or Schonlein-Henoch is a variety of purpura characterized by impairment of tiny blood vessels (capillaries) and some consider to be the result of an allergic problem. This is purpura, which concerns mainly children and rarely the adults and is manifested by attacks on the legs and buttocks. Generally the lower limb joints are swollen and painful (arthralgia). The patient sometimes complains also by abdominal pain due to intestinal purpura. If the patient complains of abdominal pain and it appears simultaneously purpura, it is possible that this is one of rheumatoid purpura (Schonlein-Henoch). Sometimes the diagnosis of appendicitis is advanced because it does not appear purpura in lower limbs. Quite often the disease causes the appearance of one or several attacks of purpura evolving without complications in a few weeks and leaving no trace, no sequelae. Sometimes purpura Schonlein-Henoch evolves, less favorably due to complications such as the presence of albumin or blood within the urine.

        This syndrome is most often benign and mainly affects children around 3 to 7 years but also young adults. There was deposition oft ype A immunoglobulin visible by immunofluorescence within the affected tissue. On the other hand, the vessel inflammation (vasculitis) is regarded as leukocytoclastic. This means that there are deposits within vessel walls, remnants of granulocytes (variety of white blood cells) that are fragmented.

Henoch purpura Symptoms

        The onset is characterized by:

• An infection in the ENT area in particular but also of the respiratory system.
• A asthenia (tiredness).
• A slight fever.
• Anorexia (loss of appetite).
• Digestive disorders: nausea, vomiting, diarrhea.

        Then appear (after three weeks or less):

• Rash serving mainly the lower limbs and face, upper limbs and the rest of the body is rarely achieved (except elbow). Generally, these rashes appear in crops.
• A purpura: abnormal flow of blood to the skin. Purpura should not be confused with a bruise, which is a brand of dark blue skin color. This purpura is located at the extensor surfaces of the lower limbs, sometimes in the forearm. The purpura usually is preceded or accompanied by hives.
• Purple spots on type of petechiae (small purplish red skin patches, caused by seepage of blood under the skin) with a slight relief appear mainly on the limbs .
• Spots resembling those appearing after a sting nettles (urticarial wheal).
• Joint pain. This arthritis (joint inflammation) localized mainly in the lower limbs is usually associated with joint effusions.
• Abdominal pain is accompanied by violent vomiting and diarrhea and sometimes there is the presence of blood in the stool (melena). The term melena refers to the evacuation through the anus of black blood mixed with stool or not.

Henoch purpura prognosis

        Recurrences can occur and sometimes for several months or years. The prognosis of renal disease is also good for the most part, but some patients can maintain long traces of protein in their urine or remain with hypertension or renal insufficiency. In children, purpura accounts 3% of all cases of chronic renal failure.

Henoch purpura pictures

Rheumatoid purpura treatment

        Most events resolve spontaneously. In cases of renal disease or severe GI, treatment with corticosteroids and immunosuppressive sometimes is necessary. In cases of severe renal disease, plasma exchange can also be made to complement, but it's effectiveness is still uncertain.