2nd most common presentation 84%
Usually transient or migratory
Lower extremity large joints
50% of patients complain of colicky pain
typically develop within 8 days of the
appearance of rash.
GI bleeding in 20 – 30 %
Inussusception is a common complication in
Ranges from 21-54 %
Hematuria with or without red cell cast.
Proteinuria ranges from mild to nephrotic range.
Elevated creatinine and/ or HTN.
CNS including intracerebral hemorrhage.
Keratits and uveitis
Renal biopsy is reserved
for patients in whom the
diagnosis is uncertain or
evidence of sever renal
Skin biopsy including
small blood vessels of
Other small vs
Admission is warranted for the following:
• Sever abdominal pain
• GI bleeding
• Elevated creatinine, HTN, and/ or nephrotic
• Sever joint involvement
• Changes in mental status
• Includes adequate hydration, rest and pain
• Naproxen 10 – 20 mg/kg
• Ibuprofin and other NSAIDs are equally
• Their use in patients with HSP is controversial
• Prednisone 1- 2 mg /kg daily (max 80 mg)
• To be used only in patients with symptoms
sever enough to affect oral intake or daily
Disease modifying agents:
• Targeted toward preventing or ameliorating GI
and renal complications.
• Limited data suggest that cyclophosphamide
and cyclosporine may be beneficial.
• Plasmapharesis has been used in patients with
crescentic disease and rapidly progressive