eMedicine Specialties > Emergency Medicine > Hematology & Oncology

Henoch-Schonlein Purpura: Follow-up

Author: Philip Bossart, MD, Professor, Department of Surgery, Division of Emergency Medicine, University of Utah Hospital, University of Utah School of Medicine
Contributor Information and Disclosures

Updated: Jun 18, 2009

Follow-up

Further Inpatient Care

  • Patients with severe abdominal pain, significant gastrointestinal bleeding, or marked renal insufficiency may require hospitalization.

Prognosis

  • Henoch-Schönlein purpura (HSP) is generally a benign disease with an excellent prognosis.
  • More than 80% of patients have a single isolated episode lasting a few weeks.
  • Approximately 10-20% of patients have recurrences.
  • Fewer than 5% of patients develop chronic Henoch-Schönlein purpura.
  • Abdominal pain resolves spontaneously within 72 hours in most patients.

Patient Education

Miscellaneous

Medicolegal Pitfalls

  • Failure to differentiate scrotal edema, which may be a common finding, from testicular torsion
  • Failure to perform the required evaluation in patients with severe abdominal pain to rule out intussusception, bowel perforation, bowel ischemia, or pancreatitis
 


More on Henoch-Schonlein Purpura

Overview: Henoch-Schonlein Purpura
Differential Diagnoses & Workup: Henoch-Schonlein Purpura
Treatment & Medication: Henoch-Schonlein Purpura
Follow-up: Henoch-Schonlein Purpura
Multimedia: Henoch-Schonlein Purpura
References
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References

  1. Blanco R, Martinez-Taboada VM, Rodriguez-Valverde V, Garcia-Fuentes M, Gonzalez-Gay MA. Henoch-Schonlein purpura in adulthood and childhood: two different expressions of the same syndrome. Arthritis Rheum. May 1997;40(5):859-64. [Medline].

  2. Szer IS. Henoch-Schonlein purpura. Curr Opin Rheumatol. Jan 1994;6(1):25-31. [Medline].

  3. Gedalia A. Henoch-Schönlein purpura. Curr Rheumatol Rep. Jun 2004;6(3):195-202. [Medline].

  4. Pillebout E, Thervet E, Hill G, Alberti C, Vanhille P, Nochy D. Henoch-Schonlein Purpura in adults: outcome and prognostic factors. J Am Soc Nephrol. May 2002;13(5):1271-8. [Medline].

  5. O'Brien WM, O'Connor KP, Horan JJ, Eggli DF, Gibbons MD. Acute scrotal swelling in Henoch-Schonlein syndrome: evaluation with testicular scanning. Urology. Apr 1993;41(4):366-8. [Medline].

  6. [Best Evidence] Chartapisak W, Opastiraku S, Willis NS, Craig JC, Hodson EM. Prevention and treatment of renal disease in Henoch-Schönlein purpura: a systematic review. Arch Dis Child. Feb 2009;94(2):132-7. [Medline].

  7. Saulsbury FT. Clinical update: Henoch-Schönlein purpura. Lancet. Mar 24 2007;369(9566):976-8. [Medline].

  8. Huber AM, King J, McLaine P, Klassen T, Pothos M. A randomized, placebo-controlled trial of prednisone in early Henoch Schönlein Purpura [ISRCTN85109383]. BMC Med. Apr 2 2004;2:7. [Medline].

  9. [Best Evidence] Ronkainen J, Koskimies O, Ala-Houhala M, et al. Early prednisone therapy in Henoch-Schonlein purpura: a randomized, double-blind, placebo-controlled trial. J Pediatr. Aug 2006;149(2):241-7. [Medline].

  10. Flynn JT, Smoyer WE, Bunchman TE, Kershaw DB, Sedman AB. Treatment of Henoch-Schönlein Purpura glomerulonephritis in children with high-dose corticosteroids plus oral cyclophosphamide. Am J Nephrol. Mar-Apr 2001;21(2):128-33. [Medline].

  11. Szer IS. Henoch-Schonlein purpura: when and how to treat. J Rheumatol. Sep 1996;23(9):1661-5. [Medline].

  12. [Best Evidence] Weiss PF, Feinstein JA, Luan X, Burnham JM, Feudtner C. Effects of corticosteroid on Henoch-Schönlein purpura: a systematic review. Pediatrics. Nov 2007;120(5):1079-87. [Medline].

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Further Reading

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Keywords

Henoch-Schonlein purpura, Henoch-Schönlein purpura, HSP, symptoms, treatment, vasculitis, small-vessel vasculitis, purpura, arthritis, skin rash, spots, abdominal pain, hematuria, nonthrombocytopenic purpura, purpura rheumatica, upper respiratory illness, URI, HSP nephritis, immunoglobulin A nephropathy, IgA nephropathy, rash, subcutaneous edema, scrotal edema, palpable purpura, HSP-related intussusception, idiopathic thrombocytopenic purpura, ITP, thrombotic thrombocytopenic purpura, TTP

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Contributor Information and Disclosures

Author

Philip Bossart, MD, Professor, Department of Surgery, Division of Emergency Medicine, University of Utah Hospital, University of Utah School of Medicine
Philip Bossart, MD is a member of the following medical societies: American College of Emergency Physicians
Disclosure: Nothing to disclose.

Medical Editor

Edmond A Hooker II, MD, DrPH, FAAEM, Assistant Professor, Department of Health Services Administration, Xavier University; Associate Clinical Professor, Department of Emergency Medicine, University of Louisville; Assistant Clinical Professor, Department of Emergency Medicine, Wright State University
Edmond A Hooker II, MD, DrPH, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American Public Health Association, Society for Academic Emergency Medicine, and Southern Medical Association
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: eMedicine Salary Employment

Managing Editor

Jeffrey L Arnold, MD, FACEP, Chairman, Department of Emergency Medicine, Santa Clara Valley Medical Center
Jeffrey L Arnold, MD, FACEP is a member of the following medical societies: American Academy of Emergency Medicine and American College of Physicians
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Steven C Dronen, MD, FAAEM, Director of Emergency Services, Director of Chest Pain Center, Department of Emergency Medicine, Ft Sanders Sevier Medical Center
Steven C Dronen, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

 
 
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