Henoch–schönlein Purpura

Henoch–schönlein Purpura is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

IgA vasculitis

Etiology

  • Mechanism: Increased serum IgA complexes with vascular deposition, activation of 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)
    • Drugs: Penicillin, tetracycline, aspirin, sulfonamides, erythromycin
    • Allergens: Insect bites, chocolate, milk, wheat
  • Incidence: Primarily school-aged children and young adults, peak in 4–6 yr olds
  • More common in whites
  • Males > females
  • Occurs more often in winter 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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Basics

Description

IgA vasculitis

Etiology

  • Mechanism: Increased serum IgA complexes with vascular deposition, activation of 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)
    • Drugs: Penicillin, tetracycline, aspirin, sulfonamides, erythromycin
    • Allergens: Insect bites, chocolate, milk, wheat
  • Incidence: Primarily school-aged children and young adults, peak in 4–6 yr olds
  • More common in whites
  • Males > females
  • Occurs more often in winter 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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