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Henoch-Schonlein purpura (HSP) is a disease that causes small blood vessels in the skin to leak because of inflammation. The primary symptom is a rash that looks like many small raised bruises on the legs. The rash is most often on the legs and buttocks, but it can appear on other parts of the body. Some people with HSP also develop abdominal pain or joint pain (arthritis). The kidneys may be affected as well, causing blood or protein in the urine. HSP can occur any time in life, but it usually happens in children between the ages of 2 and 11.
In most cases, HSP lasts four to six weeks, with no long-term consequences. Sometimes symptoms come and go during this time period. About one in three people have more than one episode (recurrence) of HSP. Recurrences usually occur within a few months and are usually less severe than the initial episode. Even when it lasts longer than a few months, HSP can still resolve completely. In a few cases, however, it can lead to kidney damage and permanent kidney failure. A person with severe kidney failure must receive a blood-cleansing treatment called dialysis or a kidney transplant if the damage is permanent.
Another rare complication of HSP is intussusception of the bowel, or intestine. With this condition, a section of the bowel folds into itself like a telescope. The bowel may become blocked as a result. Surgery may be needed to correct the problem.
What Are the Causes of HSP?
The causes of HSP are not fully understood. One theory is that it may develop as an immune response to an infection. In other words, the body’s infection-fighting system, the immune system, continues to attack cells after the infecting organisms are gone. For example, HSP may develop after a cold. The cold germs cause your immune system to take action. Once the immune cells have rid the body of the germ cells, they normally rest. But with HSP, the immune cells continue to attack other cells in the body. This theory also is based on the fact that, in many cases, HSP symptoms recur or worsen during upper respiratory infections.
HSP also has been associated with insect bites and exposure to cold weather. Other cases have developed after a person received vaccination for typhoid, measles, cholera, hepatitis B or yellow fever. Some foods, drugs or other chemical toxins may trigger HSP as well. Often no cause can be found.