Henoch Schonlein Purpura in Childhood

Abstract

Henoch Schönlein purpura (HSP) is one of the most common vasculitis in childhood characterized by nonthrombocytopenic purpura, abdominal pain, arthritis, and glomerulonephritis. Depending on the anatomical sites of involvement many other manifestations including every other organ of the body can be seen. However the most important involvement determining the longterm prognosis is the severity of renal disease. The pathogenesis of HSP is not clear, but it is believed to be an immunoglobulin-mediated inflammatory process resulting from immune complex reaction to various antigenic stimuli. Although none of them has been confirmed to be the exact cause, many bacterial, viral and parasitic infections, insect bites, vaccinations, and exposure to drug and dietary allergens have been described as triggering factors for HSP. Immune complexes are deposited in the vascular walls and mesangium triggering the mediators of inflammation. Treatment of HSP is supportive, and a clear advantage of glucocorticoids over supportive therapy has not been shown in the management of the disease except rapidly progressive type of glomerulonephritis. In this article the epidemiological, clinical and pathogenetic features, current treatment strategies, and outcome of the disease will be reviewed.