IgA vasculitis (Henoch-Schonlein purpura)

Last reviewed: 30 May 2022
Last updated: 11 Jun 2021

Summary

Definition

History and exam

Key diagnostic factors

  • rash
  • arthralgias
  • abdominal pain
  • signs of renal disease
More key diagnostic factors

Other diagnostic factors

  • drug history
  • scrotal pain or swelling
  • headaches
  • seizures
  • pulmonary hemorrhage
Other diagnostic factors

Risk factors

  • genetics
  • male sex
  • age 2 to 10 years
  • increasing age at onset
  • winter season/prior infection
  • medication
More risk factors

Diagnostic investigations

1st investigations to order

  • blood pressure
  • urinalysis
  • serum creatinine and electrolyte levels
More 1st investigations to order

Investigations to consider

  • serum IgA levels
  • CBC and coagulation studies
  • skin biopsy
  • renal biopsy
  • ultrasound, abdomen
  • ultrasound, testicles
More investigations to consider

Treatment algorithm

ACUTE

mild nephritis: normal GFR and mild or moderate proteinuria

moderate nephritis: <50% crescents on renal biopsy and impaired GFR or severe persistent proteinuria

severe nephritis: >50% crescents on renal biopsy and impaired GFR or persistent proteinuria

ONGOING

persistent proteinuria

Contributors

Authors

Louise Oni, MBChB, MRCPCH, MA, PhD

Senior Lecturer in Paediatric Nephrology and Honorary Consultant Paediatric Nephrologist

University of Liverpool

Department of Paediatric Nephrology

Alder Hey Children's NHS Foundation Trust Hospital

Liverpool

UK

Disclosures

LO is an author of references cited in this topic.

Peer reviewers

R. John Presutti, DO

Consultant

Department of Family Medicine

Mayo Clinic

Jacksonville

FL

Disclosures

RJP declares that he has no competing interests.

Rajan Madhok, MD, FCRP

Consultant Physician and Rheumatologist

Centre for Rheumatic Diseases

Glasgow Royal Infirmary

Glasgow

UK

Disclosures

RM declares that he has no competing interests.

Richard A. Watts, MA, DM, FRCP

Consultant Rheumatologist

Ipswich Hospital NHS Trust

Ipswich

UK

Disclosures

RAW declares that he has no competing interests.

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