Henoch-Schönlein purpura natural history, complications and prognosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview[edit | edit source]

Henoch-Schönlein purpura is a self-limiting illness in the majority of patients but can rarely lead to complications such as proteinuria, End Stage Renal Disease, myocardial infarction, pulmonary hemorrhage, pleural effusion, intussusception, orchitis, GI bleeding, bowel infarction, seizures, neuropathies. The prognosis is usually good but rarely its worse in adults with renal involvement.

Natural History[edit | edit source]

• The natural history of HSP is as follows:^{[1][2][3][4][5][6][7]}
• Henoch-Schönlein purpura is a self-limiting illness in the majority of patients.
• The abdominal and joint pain may be debilitating, and steroids have been used with some success in relieving the abdominal pain.
• The vasculitis of the gastrointestinal tract causes significant blood loss and occasionally leading to bowel ischemia, which may necessitate bowel resection.
• There is no clear evidence that remedy alters the progression of the HSP, however, the significant long-term morbidity related to the renal disease that has led to trials of steroids and other immunosuppressive drugs.

Complications[edit | edit source]

The complications of the HSP are as follows:^{[1][2][3][4][5][6][7]}

• Renal involvement- Proteinuria, End Stage Renal Disease in 1% of patients.

• Other complications
  • Myocardial infarction
  • Pulmonary hemorrhage
  • Pleural effusion
  • Intussusception of both small and large intestines
  • Orchitis
  • GI bleeding
  • Bowel infarction
  • Seizures
  • Neuropathies.

Prognosis[edit | edit source]

• The prognosis of the HSP:^{[8][2][9][10][11][12]}
• Henoch-Schönlein purpura is an acute self-limited illness, can seldom cause complications.
• Initial attacks of HSP can last for several months. One in every four patients will have one or more recurrences.
• HSP is more benign, short course and less recurrent in children less than three years.
• CKD can progress more than 10 years after the initial HSP attack.
• The long-term prognosis of HSP depends on the extent of the kidney involvement.
• Renal involvement of more common and the prognosis is worst in adults with HSP than the children.

References[edit | edit source]

Template:WH Template:WS