IgA vasculitis (henoch schloein purpura)

Question 1

What is IgA vasculitis (henoch schonlein purpura) (RF, Sx)

Answer 1

most common child vasculitis -affects small vessels

RF - preceded by URTI (2-3 days), boys 3-10 y, peaks in winter
if URTI/infec few weeks ago -think post-infectious glomerulonephrtiis

Sx
Always see pupuric rash on extensor surface of legs (back), arms, buttocks, trunk
80%- artharlgia and articular oedema -large joints with pain (mainly ankle and knees
60% abdo pain -colicky abdi pain, heamatemasis, melena -RF FOR INTUSSUSEPTION
Glomerulonephritis -97% within 3m of onset
micro/macroscopic heamturia
rarely -nephrotic

complications testticular pain, arhtirits, intussuception, pancreatitis, acute renal failure

Question 2

Ix and Mx of IgA vasculitis (henoch Schonlein purpura) (and complications)

Answer 2

1st -FBC, clotting, U&E -normal, exclude menigococcal SEPSIS
Urine dipstick - blood, proteins, urea, creat
Urinanalysis -show RBC/casts, proteinuria
BP -crucial to assess renal involve -raised
(keep checking these even if normal)
IgA levels raied
follow up (weekly 1st motn, 2 weekly 2m more, 3m, 6m, 12m)
measure BP and urine dipstick

Mx
most cases resolve spontaneously -
NSAID for pain,
if scrotal involve, oedema, abdo pain -oral prednisoline
Renal involve - IV cortico, renal transplant can be needed (often adults)

complications testticular pain, arhtirits, intussuception, pancreatitis, acute renal failure