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$Unique_ID{BRK04157}
$Pretitle{}
$Title{Purpura, Schonlein-Henoch; Allergic Purpura}
$Subject{Purpura, Schonlein-Henoch Anaphylactoid Purpura Allergic Purpura
Henoch-Shonlein Purpura Rheumatic Purpura Nonthrombocytopenic Idiopathic
Purpura Peliosis Rheumatica Hemorrhagic Capillary Toxicosis Henoch's Purpura
Shonlein's Purpura Scurvy Gardener-Diamond Syndrome Common Purpura}
$Volume{}
$Log{}
Copyright (C) 1987, 1989 National Organization for Rare Disorders, Inc.
405:
Purpura, Schonlein-Henoch
Allergic Purpura
** IMPORTANT **
It is possible the main title of the article (Schonlein-Henoch Purpura)
is not the name you expected. Please check the SYNONYMS listing on the next
page to find alternate names, disorder subdivisions, and related disorders
covered by this article.
Synonyms
Anaphylactoid Purpura
Allergic Purpura
Henoch-Shonlein Purpura
Rheumatic Purpura
Nonthrombocytopenic Idiopathic Purpura
Peliosis Rheumatica
Hemorrhagic Capillary Toxicosis
DISORDER SUBDIVISIONS
Henoch's Purpura
Shonlein's Purpura
Information on the following diseases can be found in the Related
Disorders section of this report:
Scurvy
Gardener-Diamond Syndrome
Common Purpura
General Discussion
** REMINDER **
The information contained in the Rare Disease Database is provided for
educational purposes only. It should not be used for diagnostic or treatment
purposes. If you wish to obtain more information about this disorder, please
contact your personal physician and/or the agencies listed in the "Resources"
section of this report.
Shonlein-Henoch Purpura is one of a group of disorders characterized by
purplish or brownish red discolorations on the skin. These spots may be
large or small. Internal bleeding may occur in various areas of the body.
This blood vessel disorder may affect the skin, joints, gastrointestinal
system, kidneys, and in a very few cases the central nervous system. Little
is known about the cause of this form of purpura although it may be an
allergic reaction which more often occurs in children than in adults. Some
cases of Shonlein-Henoch characterized by joint disease without
gastrointestinal problems are termed Shonlein's Purpura. Another form
characterized by acute abdominal symptoms but without joint disease is known
as Henoch's Purpura. This disorder runs a limited course with a good
prognosis in most cases.
Symptoms
The first symptom of Shonlein-Henoch Purpura is usually reddening of the
skin, slight swelling and a rash (hives). These hives are associated with
inflammation of small blood vessels and/or bleeding under the skin with a
brown or reddish-purple appearance. The hives seem to appear on the buttocks
and lower extremities in most cases but may spread and/or become more severe.
Fever and a general feeling of discomfort or weakness may also be present.
Blood and plasma may accumulate in the joints or abdomen producing acute
local pain. Iron deficiency anemia may develop because of gastrointestinal
bleeding. Other gastrointestinal disturbances such as vomiting or blood in
the stool may also occur.
Central nervous system complications of Shonlein-Henoch Purpura may
include headaches, perceptual changes and/or seizures. Kidney inflammation
or lesions, which occur in approximately ten percent of cases, may signify a
more serious form of this type of purpura and can appear at any time during
the course of this illness.
Causes
The exact cause of Shonlein-Henoch Purpura is unknown. Some medical
researchers believe it may be an extreme allergic reaction to certain foods
(such as chocolate, milk, eggs or beans), various drugs or insect bites in
sensitive people.
At times, infections of the upper respiratory tract or Rubella (German
Measles) have preceded outbreaks of Shonlein-Henoch Purpura, but no definite
link with viral infections has been proven.
Affected Population
Shonlein-Henoch Purpura is most commonly observed in children but can occur
at any age. It appears to affect males slightly more often than females with
a ratio of thirty-five males to twenty-five females in one study.
Related Disorders
The Purpuras are a group of disorders characterized by purplish or brownish
red discolorations on the skin. These spots may be large or small and are
caused by bleeding into the skin tissue where the spots appear.
Symptoms of the following disorders can be similar to Shonlein-Henoch
Purpura. Comparisons may be useful for a differential diagnosis:
Common Purpura is the most prevalent type of purpura and is characterized
by the unusual appearance of spots (black and blue marks) that signify easy
bruising. This inherited condition occurs most frequently in women over 50
years of age, particularly those whose skin tissue has become thinner. In
the absence of serious injury, unsightly bruises tend to appear rather than
significant bleeding under the skin. Fragility of the blood vessels in
affected individuals can lead to excessive bleeding following surgery or even
minor injury. The blood vessel walls may also become thinner due to some
types of illnesses, infection, hypothyroidism, and/or excessive exposure to
certain drugs. No standard therapy has been found for treating common
purpura although brief courses of corticosteroids may help reduce bleeding.
Estrogen may be administered to affected women after menopause to help
alleviate the tendency to bleed excessively. (To locate information on other
types of purpura, or purpura as a symptom of other diseases, choose "purpura"
as your search term in the Rare Disease Database).
Scurvy is a type of purpura due to deficiency of ascorbic acid (Vitamin
C) in the diet. It is marked by weakness, anemia, spongy gums, a tendency to
bleed under the skin and in the mucous membranes. Adequate Vitamin C in the
diet can cure this disorder.
Gardener-Diamond Syndrome is a type of purpura occurring chiefly in young
women. Spontaneous, painful, recurrent blue or purplish spots may appear on
any part of the body unrelated to apparent injury. It has been suggested
that this disorder may be triggered by the body's immune system attacking a
specific component of blood cells. Gardner-Diamond is also called "Painful
Bruising Syndrome".
Therapies: Standard
If a patient is found to be allergic to a substance which precipitated the
attack of Shonlein-Henoch Purpura, that substance should be avoided. Other
treatment is symptomatic and supportive. Mild cases in children tend to
improve spontaneously with age. No specific therapy for cases with kidney
involvement has been found, but hemodialysis may be of benefit in severe
cases with renal failure.
Therapies: Investigational
Treatment with a combination of anticoagulants (heparin and acenocoumarol),
corticosteroids, and immunosuppressive drugs has been tested for treatment of
adults with severe cases of Shonlein-Henoch Purpura. Immunosuppressive drug
therapy (cyclophosphamide) alone has been used in a few cases with some
success. Plasmapheresis (a method for removing unwanted substances such as
toxins, metabolic substances and plasma parts from the blood by separating
plasma from blood cells has been tried. More research on the use of
plasmapheresis as a treatment for Shonlein-Henoch Purpura is needed before
effectiveness can be evaluated.
This disease entry is based upon medical information available through
February 1988. Since NORD's resources are limited, it is not possible to
keep every entry in the Rare Disease Database completely current and
accurate. Please check with the agencies listed in the Resources section for
the most current information about this disorder.
Resources
For more information on Shonlein-Henoch Purpura, please contact:
National Organization for Rare Disorders (NORD)
P.O. Box 8923
New Fairfield, CT 06812-1783
(203) 746-6518
National Kidney Foundation
2 Park Avenue
New York, NY 10016
(212) 889-2210
(800) 622-9010
American Kidney Fund
6110 Executive Blvd., Suite 1010
Rockville, MD 20852
(301) 881-3052
(800) 638-8299
(800) 492-8361 (MD)
NIH/National Institute of Allergy and Infections Diseases (NIAID)
9000 Rockville Pike
Bethesda, MD 20892
(301) 496-5717
NIH/National Heart, Lung and Blood Institute (NHLBI)
9000 Rockville Pike
Bethesda, MD 20892
(301) 496-4236
References
SCHONLEIN-HENOCH SYNDROME IN ADULTS: D.A. Roth, et al.; Q J Med (May
1985, issue 55(217)). Pp. 145-152.
CLINICAL ASPECTS OF THE NEPHROPATHY IN SCHONLEIN-HENOCH SYNDROME: E.
Verrina, et al.; Pediatr Med Chir (May-June 1986, issue 8(3)). Pp. 317-320.
NEUROLOGICAL MANIFESTATIONS OF SCHONLEIN-HENOCH PURPURA: REPORT OF
THREE CASES AND REVIEW OF THE LITERATURE: A.L. Belman, et al.; Pediatrics
(April 1985, issue 75(4)). Pp. 687-692.