PURPURA, ALLERGIC (Anaphylactoid Purpura; Henoch-Schronlein Purpura)
(Anaphylactoid Purpura; Henoch-Schronlein Purpura)
DESCRIPTIONAllergic purpura is an allergic disorder. The joints (usually knees, ankles, hips, wrists, and elbows), the skin of the legs, thighs, and abdomen, the gastrointestinal tract, and the kidneys are involved. Allergic purpura can affect both sexes, all ages, but is more common in boys (2 to 8 years).
Appropriate health care includes:
Home care after diagnosis.
Physician's monitoring of general condition and medications.
Hospitalization (for complications).
SIGNS & SYMPTOMSSore throat about 2 weeks prior to other symptoms.
Itching skin rash that seems to be just beneath the skin surface. The rash usually consists of large hives with small bruises or blood spots in the centers. The rash is most often on the legs, thighs, and lower abdomen, but it may be scattered over your child's body.
Joint inflammation at the knees, ankles, hips, wrists, or elbows.
Cramping abdominal pain and vomiting.
Protein and blood in the urine.
Purpura is probably an allergic reaction in the inflamed small blood vessels throughout the body. The allergic trigger is not known, but attacks often follow an upper-respiratory infection or the use of some drugs, especially sulfa drugs.
RISK FACTORSRecent illness, especially a bacterial sore throat.
Use of sulfa drugs.
PREVENTING COMPLICATIONS OR RECURRENCE
Don't allow your child to be exposed to respiratory infections, if possible.
Obtain prompt medical treatment of any bacterial throat infection.
Avoid the use of any drug that has triggered allergic purpura in your child. Consult the doctor before giving any medication to a child.
Your own observation of symptoms.
Medical history and physical exam by a doctor.
Laboratory blood studies and a urinalysis.
Kidney failure, resulting from kidney inflammation and damage.
Permanent joint deformity.
PROBABLE OUTCOMEAllergic purpura usually lasts 1 to 3 weeks. Some children only have a few spots and fever. Others require hospitalization for severe abdominal pain and kidney inflammation.
Most children with allergic purpura recovery completely. In some, however, allergic purpura recurs or persists for years.
HOME CAREUse warm soaks to relieve your child's joint pain.
MEDICATIONYour doctor may prescribe cortisone drugs or immunosuppressive drugs, such as cyclophosphamide, for your child to suppress inflammation. Effectiveness of treatment varies.
See Medications section for information regarding medicines your doctor may prescribe.
If your child has fever or pain, encourage bed rest. The child may sit up for meals and walk to the bathroom. When fever and pain are gone, the child may gradually resume normal activities as strength and well-being allow.
DIET & FLUIDS
Your child should eat a normal, well-balanced diet. Vitamin and mineral supplements should not be necessary unless the child shows evidence of deficiency.
OK TO GO TO SCHOOL?When appetite has returned and alertness, strength, and feeling of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of allergic purpura.
The following symptoms occur during treatment:
-- Unrelenting abdominal pain.
-- Blood in the stool.
-- Black, tarry bowel movements.
-- New bleeding under the skin.
-- Blood in the urine.