Schoenlein-Henoch purpura should be considered if a child or baby develops a fever with swelling in the extremities after the flu or a childhood illness has already subsided. This disease is also associated with punctiform skin bleeding, which sometimes look like blood blisters.
What is Henoch-Schoenlein Purpura?
Schoenlein-Henoch purpura is an inflammatory disease of the blood vessels triggered by the immune system. In the run-up, there may be a slight fever and pain, later the small and medium-sized vessels in particular lose stability and the blood can penetrate the overlying skin. See topbbacolleges for Definitions of Liver Failure.
The punctiform skin hemorrhages that are typical of this disease occur, which are also known as petechiae. There is also swelling on the backs of the feet and hands due to the accumulation of tissue fluid in these areas. The affected children are conspicuous by a sudden restriction of movement.
In some cases, Schoenlein-Henoch purpura can also cause inflammation of the kidneys or intestines, since the disease can also manifest itself on the mucous membranes. This leads to bloody diarrhea and blood in the urine. The disease progresses in phases that last several weeks. Children up to school age are particularly affected, but hardly any babies or young people.
Causes
In most cases, purpura Schoenlein-Henoch is the result of a previous illness such as chickenpox, rubella or measles and occurs up to three weeks after these infections. Schoenlein-Henoch purpura can also occur after a simple flu infection or after an infection with influenza A viruses and other diseases that primarily affect the upper respiratory tract.
Taking medication is very rarely the cause of this immune response. In individual cases, there is therefore no recognizable cause for the occurrence of the disease. It is not yet known why Schoenlein-Enoch purpura manifests itself. However, allergic reactions of the patient to the pathogens are assumed to be the trigger for the sudden inflammatory reactions.
Symptoms, Ailments & Signs
The first symptoms usually start suddenly. They don’t appear continuously, but come in batches. The children feel ill, suffer from loss of appetite, stomach cramps and headaches. The characteristic signs of Schoenlein-Henoch purpura then follow as the process progresses: small punctiform hemorrhages (petechiae) of initially only a few millimeters in diameter.
Over time, they enlarge and join together to form larger patches. Most often they are found on the buttocks and lower legs. They do not itch, cannot be pushed away, are slightly raised and palpable. As a rule, they are distributed symmetrically on the body. Furthermore, the petechiae can also develop in the digestive tract, which leads to bloody diarrhea and colicky abdominal cramps.
They can also affect the kidneys and cause bloody urine. When they affect the joints, there is restricted movement and swelling, often in the knee and ankle joints. In boys, they very rarely form on the testicles or arms.
In exceptional cases, the brain can be affected by the petechiae, which leads to paralysis, seizures or even loss of consciousness. An extreme complication of the disease is when the patches begin to bleed and become necrotic, causing tissue death. In this case, the life of the child is at risk.
Diagnosis & History
Purpura Schoenlein-Henoch is diagnosed by the doctor based on the typical circular and merging skin bleeding. These occur on the lower abdomen and buttocks as well as on the lower legs and feet. In boys, they can also be visible on the testicles. Other symptoms such as abdominal pain and bloody diarrhea indicate intestinal involvement.
However, these symptoms only appear about a week or two after the skin reactions. Delayed kidney dysfunction is also possible. Then blood and protein are found in the urine during laboratory tests. In addition, blood pressure may also be elevated. More than 30 percent of affected children suffer from kidney dysfunction during the course of Schoenlein-Henoch purpura.
Complications
Schoenlein-Henoch purpura leads to a number of different unpleasant symptoms in the patient. There is usually bleeding on the skin. These can occur in different parts of the body and are often associated with pain. Likewise, the affected regions of the body are often swollen and pain in the joints occurs.
Due to the joint pain, patients often also suffer from restricted mobility and thus from difficulties in everyday life. Pain in the abdomen or stomach can also occur as a result of Schoenlein-Henoch purpura. There is also blood in the stool and urine. The blood pressure itself is also increased by Schoenlein-Henoch purpura, making it easier for other diseases to develop.
As a rule, no special treatment of this disease is necessary. With the help of bed rest and relaxation, the disease can be fought by the body. Likewise, medication can continue to support the treatment. Usually there are no complications. The life expectancy of the patient is also not affected if the disease is successfully treated. If left untreated, Schoenlein-Henoch purpura can also lead to renal insufficiency.
When should you go to the doctor?
Medical treatment is always necessary for Schoenlein-Henoch purpura. This disease does not heal itself and the disease cannot usually be treated by self-help. Only medical treatment can prevent further complications and symptoms. A doctor should be consulted if the person concerned suffers from severe abdominal pain and loss of appetite. This can also lead to pain in the head or small bleeding all over the body.
If these symptoms persist and do not go away on their own, a doctor must be consulted. Even with severe diarrhea, purpura Schoenlein-Henoch must be treated. Swelling or restricted movement can also indicate the disease and should be examined by a doctor. The earlier Schoenlein-Enoch purpura is treated, the higher the probability of a complete cure. In the worst case, the tissue can die off completely.
Treatment & Therapy
In most cases, purpura Schoenlein-Henoch heals on its own within a few days. There are no drugs specifically designed to treat this condition. The child should be kept in bed for rest. In the case of bloody diarrhea, the immune reaction is weakened with cortisone so that the intestine can recover.
Treatment is more difficult when kidney function worsens. In the case of the so-called Schoenlein-Henoch nephritis, the severity of the disease must be determined by means of a kidney biopsy. Kidney function can be improved by administering cortisone or other drugs that artificially suppress the immune system. Increased blood pressure resulting from kidney disease is also treated with appropriate medication.
With this severe course of purpura Schoenlein-Henoch, it takes about four to six weeks for the child to fully recover. After the disease, kidney function must be checked at regular intervals for several years, as it can deteriorate again over time. However, the occurrence of kidney failure or shock due to sudden, extensive bleeding of the skin is extremely rare. Schoenlein-Henoch purpura can recur in children.
Prevention
There are no preventive measures for Schoenlein-Henoch purpura. If unusual skin symptoms are discovered in babies and young children, a doctor should be consulted as soon as possible. This ensures monitoring in the event of a potentially severe course of Schoenlein-Henoch purpura.
Aftercare
Schoenlein-Henoch purpura does not require any special causal aftercare. Since it is a multisystem disease, there can be various complaints that are treated symptomatically. In severe cases of the disease, cortisone therapy may be prescribed. Prescribing immunosuppressants may also be necessary. In addition, taking painkillers can be recommended for pain and persistent itching. In addition, antipruritic ointments can be used to help.
After the illness, those affected should take it easy, if necessary, keep to bed rest and avoid intensive physical activities. Fish oil capsules can have a positive effect on healing. Tight clothing should also be avoided so that the skin can also recover.
Renal impairment or kidney failure caused by advanced Schoenlein-Henoch purpura requires a kidney transplant or lifelong dialysis. Since this disease has an increased tendency to recur, regular check-ups are necessary for up to two years. Above all, the kidney function is checked with the help of regular urine samples.
The prognosis for Schoenlein-Henoch purpura, especially in children, tends to be positive. Healing occurs within one to several months. In mild to normal cases, the later quality of life is generally not affected. Exceptions are cases in which kidney damage has occurred.
