Henoch-Schonlein Purpura

Question 1

Define Henoch-Schonlein Purpura (HSP)

Answer 1

HSP AKA IgA vasculitis is an immune-mediated small vessel vasculitis that primarily affects children and is characterized by the deposition of IgA immune complexes in the walls of small blood vessels, leading to inflammation.

Question 2

What type of hypersensitivity reaction is HSP?

Answer 2

Type III - IgA immune complex

Question 3

HSP pathopysiology

Answer 3

1. IgA immune complex deposition - Triggers complement and inflammation - Small vessel vasculitis
2. Leukocytoclastic vasculitis - Vessel wall damage, increased permeability - Palpable purpura, oedema
3. Multisystem involvement - Immune complex deposition in organs - Palpable purpura, arthralgia, abdo pain, IgA nephritis

Question 4

What are tha classic tetrad for HSP?

Answer 4

• Palpable purpura (non-blanching)
• Arthralgia
• Abdominal pain
• Renal involvement

Question 5

what is the most common trigger for HSP

Answer 5

URTI

Question 6

What is the most affected group in HSP?

Answer 6

Children age 3-15

Question 7

HSP Management

Answer 7

Usually self-limiting
- NSAIDs / Paracetamol
- Steroids

Question 8

Is HSP most common in boys or girls?

Answer 8

Boys

Question 9

What monitoring is essential in active HSP?

Answer 9

1. Urinalysis - for haematuria / proteinuria
2. Blood pressure - for HTN

Question 10

what pathopysiology causes purpura in HSP?

Answer 10

inflammation and leaking of blood from small blood vessels under the skin, forming purpura

Question 11

What joints are affected the most in HSP?

Answer 11

Knees
Ankles

Question 12

Petachie VS Purpura VS Echhymosis

Answer 12

• Petechiae < 4mm
• Purpura 4 - 10mm
• Echymosis > 10mm