Pediatric Henoch-Schonlein Purpura Follow-up
- Author: Pamela L Dyne, MD; Chief Editor: Richard G Bachur, MD more...
Further Inpatient Care
Patients with Henoch-Schönlein purpura (HSP) have the potential for severe complications, which may occur precipitously (eg, acute abdomen, acute scrotum, renal failure).
Whether or not to admit the patient to the hospital for observation and monitoring depends on the practice of the admitting pediatrician and his or her preference.
Further Outpatient Care
In all patients, urinalysis and blood pressure monitoring to evaluate for renal involvement should be continued for up to 6 months after presentation, even if initial urinalysis results are normal.
Complications
Henoch-Schönlein purpura can involve nearly every organ system.
GI complications include hydrops of the gallbladder, pancreatitis, and GI bleeding.
Surgical complications include intussusception, bowel infarction, and perforation.
Overall, 5% of patients develop end-stage renal disease (ESRD).
Other potential complications include the following:
- Coronary artery vasculitis resulting in myocardial infarction (MI)
- Headache
- Irritability
- Fever
- Pulmonary hemorrhage
- CNS bleeding
- Scrotal edema
- Pain
Prognosis
Most patients have complete resolution of symptoms within 8 weeks.
Up to half of all affected patients will have at least 1 recurrence.
Younger patients usually have a better prognosis than older patients.
As many as 15% of patients may have long-term renal insufficiency, but less than 1% will have end-stage renal disease.
Patients with a normal urinalysis at 6 months and without prior renal involvement have not gone on to develop kidney problems.[2]
Pregnant women who had HSP during childhood appear to be at increased risk of developing hypertension and proteinuria during pregnancy.[3]
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