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Australian Family Physician
Australian Family Physician

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Volume 38, Issue 5, May 2009

Could it be Henoch-Schönlein purpura?

Lisa N C Cheng Felix W S Wong Chi Eung Danforn Lim
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Background
Henoch-Schönlein purpura is the most common form of systemic vasculitis in the paediatric setting with 90% of cases occuring in childhood. Although diagnosis in the primary care setting may be difficult, it is vital in order to avoid significant complications.
Objective
This article outlines the pathogenesis, clinical manifestations and classification of Henoch-Schönlein purpura and details evidence based investigations and management.
Discussion
Henoch-Schönlein purpura is a self limiting disease characterised by a tetrad of clinical manifestations that vary in occurrence and order of presentation. There is no single diagnostic test to confirm Henoch- Schönlein purpura; diagnosis depends on recognition of clinical manifestations. Management usually occurs in the ambulatory setting and is mainly supportive. Priorities include symptom relief and preventive therapy to reduce the risk of complications. Further trials to clarify the role of glucocorticosteroids are needed before a definitive role for steroids in the management of Henoch-Schönlein purpura can be established.

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