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Henoch schonlein purpura
Henoch schonlein purpura
Henoch schonlein purpura
Henoch schonlein purpura
Henoch schonlein purpura
Henoch schonlein purpura
Henoch schonlein purpura
Henoch schonlein purpura
Henoch schonlein purpura
Henoch schonlein purpura
Henoch schonlein purpura
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Henoch schonlein purpura

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  • 1. Anaphylactoid purpura -Vasculitis of small vessels Henoch Schonlein Purpura CSN Vittal
  • 2. HSP  Typically follows an attack of URI  More frequent in children (2-8 yrs)  Most frequently in winter months  Males twice as frequently as females  Incidence 9/100,000 population CSN Vittal
  • 3. Pathogenesis  IgA mediated vasculitis of small vessels  Deposition of IgA & C3 in small vessels of skin and renal glomeruli  ASO titers increase - ? Group A streptococcus CSN Vittal
  • 4. Clinical  Acute  Insidious  Rash – palpable purpura  Red – purple – rusty brown – fade  Lesions in crops – last from 3-10 days  Intervals vary from 3-4 months  Local angioedema in dependent or distensible areas  Arthritis in 2/3 knees, ankles  Serous effusions – resolve without residual damage CSN Vittal
  • 5. Clinical  Edema and damage to vasculature of GI tract leads to pain abdomen – often colicky  Occult heme – positive stools, diarrhoea with or without visible blood or hematemesis  Intessusception with current jelly stools may occur (ileo-ileal)  Renal involvement in 25-50%  HSM, lymphadenopathy CSN Vittal
  • 6. Complications  Rarely CNS involvement  Seizures, peresis. Coma  Rheumatoid like nodules  Cardiac and eye involvement  Pancreatitis  Pulmonary or intramuscular hemorrhages CSN Vittal
  • 7. Diagnosis  Palpable purpura  Crops in dependant areas DD:  Kawasaki disease  Polyarteritis nodosa  Meningococcemia  Systemic JRA  Factor V Leiden / Protein C deficiency CSN Vittal
  • 8. Labs  Normal  Biopsy : confirmatory [cutaneous vasculitis] CSN Vittal
  • 9. Treatment  Symptomatic  Hydration  Pain control  Avoidance of competitive activities  GI symptoms ; IV Corticosteroids :  1-2 mg/kg/hr CSN Vittal
  • 10. Complications  Renal involvement : Nephrotic syndrome  Bowel perforation  Testicular torsion CSN Vittal
  • 11. Prognosis  Self limiting  < 1% develop renal involvement and , 0.1% develop serious renal disease  Rarely death in acute stage due to bowel infarction CSN Vittal

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