Henoch–SchöNlein Purpura (Iga Vasculitis)

Basics

Description

  • IgA vasculitis
  • Most common vasculitis in children. Nonthrombocytopenic palpable purpura, arthralgias, and abdominal pain

Etiology

  • Leukocytoclastic vasculitis caused by vascular deposition of IgA complexes and activation of an alternative complement pathway:
  • Glomerular mesangial deposition can cause mesangial proliferation to glomerulonephritis with crescent formation
  • Although cause is undefined, there are many associated conditions:
    • Infectious (Group A strep, Mycoplasma, Varicella, Epstein–Barr, COVID-19)
    • Drugs: Penicillin, tetracycline, aspirin, sulfonamides, erythromycin, biologics
    • Vaccines: MMR, Influenza, COVID-19, Hep B
    • Allergens: Insect bites
  • Primarily occurs in school-aged children and young adults, peak in 4–6 yr olds
  • More common in Caucasians and Asians
  • Males > females
  • Occurs more often in fall through early spring
  • Multisystem involvement can lead to life-threatening or long-term complications:
    • Intussusception
    • Proliferative glomerulonephritis
    • Chronic renal failure: More common in older children and adults (13–14%), higher risk in patients with hematuria and nephrotic range proteinuria
    • Intracranial hemorrhage (rare)

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