Skip to Main Content

For further information, see CMDT Part 20-25: Henoch-Schönlein Purpura

Key Features

  • The most common systemic vasculitis in children

  • Occurs in adults as well

Clinical Findings

  • Purpuric skin lesions typically located on the lower extremities; may also be seen on the hands, arms, trunk, and buttocks

  • Joint symptoms are present in most patients; the knees and ankles are most commonly involved

  • Abdominal pain secondary to vasculitis of the intestinal tract is often associated with gastrointestinal bleeding

  • Hematuria signals the presence of a glomerular lesion that is usually reversible, although it occasionally may progress to chronic kidney disease


  • Skin biopsy can demonstrate leukocytoclastic vasculitis with IgA deposition

  • Kidney biopsy reveals segmental glomerulonephritis with crescents and mesangial deposition of IgA

  • Differential diagnosis

    • Immune thrombocytopenia

    • Meningococcemia

    • Rocky Mountain spotted fever

    • Rheumatoid arthritis (including juvenile form)

    • Polyarteritis nodosa

    • Endocarditis

    • Cryoglobulinemia


  • Chronic courses with persistent or intermittent skin disease are more likely to occur in adults than children

  • The efficacy of treatment is not well established

  • In children, prednisone (1–2 mg/kg/day orally) does not decrease the frequency of proteinuria 1 year after onset of disease

  • Severe disease is often treated with aggressive immunosuppressive agents such as mycophenolate mofetil, but there is no consensus as to the efficacy of this approach or the optimal therapeutic regimen

Pop-up div Successfully Displayed

This div only appears when the trigger link is hovered over. Otherwise it is hidden from view.