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Diagnosis, treatment and management of UTI in children (D&G) Kidney Biopsy Complications Parenteral Iron for Non-HD CKD Patients Management of uncomplicated Henoch-Schonlein Purpura (HSP) in under 16s Prescribing Advice on Admission – Insulin Sodium Glucose Transporter 2 Inhibitors (SGLT2i) Gentamicin in Renal Replacement Therapy Vancomycin in Renal Replacement Therapy Haemodialysis Medication Prescribing Contrast Associated AKI Low Molecular Weight Heparin Fluid Replacement in AKI Management of Urinary Symptoms Acute Kidney Injury (AKI) Urinary Tract Infection Urethral Catheterisation Kidney Transplantation Ureteric Colic & Renal Stones Intravascular Catheter Related Blood Stream Infection Care of Vascular Access Urinary Incontinence Peritoneal Dialysis Related Peritonitis
Home | Articles | Renal | Management of uncomplicated Henoch-Schonlein Purpura (HSP) in under 16s

Management of uncomplicated Henoch-Schonlein Purpura (HSP) in under 16s

Last updated 31st January 2024

Background

Henoch-Schonlein Purpura (HSP) is an IgA-mediated systemic small vessel vasculitis

Classical symmetrical distribution of palpable purpura – predominantly over the child’s buttocks, lower limbs and ankles

Often associated with arthritis, peripheral oedema and colicky abdominal pain

May have associated renal involvement (with haematuria +/- proteinuria)

Diagnosis is uncommon < 2yrs of age; usually manifests between 3 – 10yrs

Incidence peaks throughout the winter months; often preceded by an URTI

Most cases have a benign course with remission occurring within ~ 6 weeks

At Initial presentation:

  • History and examination consistent with above features
    • Take blood for: FBC (platelet levels should be within normal range), Coagulation Screen, U&Es and Bone Profile (to monitor renal profile)
    • Blood Pressure measurement (determine BP centile based on child’s sex, age + height)
    • Urinalysis; plus send urine samples to quantify protein : creatinine ratio and for microscopy, culture & sensitivity.
    • If urine dip negative for blood and protein, bloods normal and BP normal, progress to flow chart (figure 1). Any abnormalities should be discussed with on call consultant and alternate diagnosis considered.

HSP Flowchart following diagnosis

HSP flowchart: figure 1

At discharge:

  • Refer to CCN for BP and urinalysis at one week
  • Refer to consultant clinic for review at one month
  • Subsequent follow-up will be arranged by consultant at clinic review appointment