Henoch Schönlein Purpura (HSP) PIL1036 Version 3

This leaflet tells you about Henoch Schönlein Purpura (HSP).

What is HSP?

HSP is a condition that affects different parts of the body. Tiny blood vessels in the body can become inflamed or swollen. It can cause a skin rash called ‘Purpura’ and also joint and abdominal (tummy) pain.

The exact cause of HSP is unknown. It might be triggered by a bacterial or viral infection such as a sore throat, cough or cold.

HSP affects all ages but is most often seen in children under the age of 10 years. HSP is not contagious and cannot be passed on to others.

What are the symptoms?

Symptoms can include:

• A red/purple skin rash (Purpura). This is usually on the legs, elbows and buttocks. The rash may also be itchy.
• Painful, often swollen joints, usually around the ankles and knees.
• Swelling of the hands and feet.
• Vomiting (being sick).
• Occasional swelling, especially of the scrotum (testicles) in boys.

Blood in the faeces (poo) or urine (wee), caused by the blood vessels in the bowel and the kidneys becoming inflamed, causing blood cells and proteins to ‘leak’ into the urine.

How is it diagnosed?

A doctor may suspect HSP based on your child’s symptoms. To help with the diagnosis, the following tests may be carried out in hospital:

• A blood test to look for signs of infection and to see how well your child’s kidneys are working.
• A urine dipstick test to check for blood or protein in the urine, as your child’s kidneys can sometimes be inflamed.
• Your child’s blood pressure will also be checked regularly.

How is it treated?

Usually, children with HSP do not need special treatment, but will need to be carefully monitored and your child may need to stay in hospital and/or take medicines if your doctor thinks it is needed.

HSP sometimes comes back, usually within a few months, and may need further treatment. A very small number of children who have HSP will have long-term problems, especially when their kidneys are affected.

In about half of the children, small amounts of blood or protein are found in the urine. Very rarely there may be longer term kidney problems and because of this we advise regular urine checks after the HSP has gone away.

Your child will need to rest until their symptoms have passed.

Paracetamol can be given to your child to help relieve some of the joint pains. You should always follow the instructions provided in the leaflet supplied with your medication.

Do not give ibuprofen without speaking to your doctor first.

How will I manage the symptoms at home?

If your child has been diagnosed with HSP you will need to check their urine for blood and protein on a regular basis for about

6 months.

A nurse will show you how to do this before your child is discharged home.

If blood is detected on your child’s urine dipstick, it is not usually a cause for concern and may continue for several months.

However, if the urine looks red or blood coloured, you must contact the hospital or your community nurse immediately for further advice.

If protein is detected on your child’s urine dipstick:

• + or ‘trace’ – You should continue to check your child’s urine until your child is seen in outpatients.
• ++ or more – Do the dipstick test again the next day. If it is still ++ or more of protein, telephone the Children and young person’s Emergency Department for advice (see contact numbers)

How long can HSP last?

HSP usually lasts about 6 to 8 weeks. Your child’s blood pressure and urine will be checked regularly during this time. Your child may also need further blood tests.

Are there any long term complications?

Some children have complications (health problems) that happen because of the condition.

When the kidneys are involved, this may lead to:

• Blood pressure that is too high (hypertension).
• Swelling or puffiness in different parts of the body, especially around the eyes, legs and feet (oedema). Very rarely, the kidney problems get worse quickly this may cause the kidneys to stop working over a short time (acute kidney injury).

Other complications include:

• In some boys, inflammation of the testicle (orchitis) – this may cause pain and/or swelling in the scrotum.
• A blockage in the bowel causing acute pain and passing blood in stools (intussusception) – this needs surgical treatment.
• Very occasionally, the brain, spinal cord or lungs are affected.

Can my child get HSP again?

HSP can return after your child has been symptom free for a while. If your child’s symptoms change and they become more unwell, you should seek advice from your child’s GP and your child may be referred back to the Children’s Ward for further treatment.

Contact numbers

Children’s Ward

Telephone: 01642 382815
24 hours a day, 7 days a week

Children’s and Young People’s Emergency Department

Telephone: 01642 624533
24 hours a day, 7 days a week

If you have any worries or concerns, you should contact your GP during normal surgery hours. Outside surgery hours, you should contact your GP’s surgery for the Out of Hours Service number.

Further information is available from:

NHS Website
https://www.nhs.uk/conditions/henoch-schonlein-purpura-hsp/

Comments, concerns, compliments or complaints

Patient Experience Team (PET)

We are continually trying to improve the services we provide. We want to know what we’re doing well or if there’s anything which we can improve, that’s why the Patient Experience Team (PET) is here to help. Our Team is here to try to resolve your concerns. The office is based at the University Hospital of North Tees if you wish to discuss concerns in person. Our contact details are:

Telephone: 01642 624719
Freephone: 0800 092 0084
Opening hours: Monday to Friday, 9:30am to 4:00pm
Email: [email protected]

Out of hours

Out of hours if you wish to speak to a senior member of Trust staff, please contact the hospital switchboard who will bleep the appropriate person.
Telephone: 01642 617617

Patient, Public and People with Lived Experience

We are looking for patients to share their experiences of healthcare and to join our Involvement Bank. Working with the patients, carers, families and the general population we support in making decisions about their care can lead to better health outcomes, increased patient satisfaction and a better overall experience. We want to listen and work with you in shaping the future of your healthcare services. To find out more about the Involvement Bank go to our website or contact us at:

Website: www.nth.nhs.uk/about/community/people-with-lived-experience
Email: [email protected]

Data protection and use of patient information

The Trust has developed Data Protection policies in accordance with Data Protection Legislation (UK General Data Protection Regulations and Data Protection Act 2018) and the Freedom of Information Act 2000. All of our staff respect these policies and confidentiality is adhered to at all times. If you require further information on how we process your information please see our Privacy Notices.

Telephone: 01642 383551

Email: [email protected]

Leaflet feedback

This leaflet has been produced in partnership with patients and carers. All patient leaflets are regularly reviewed, and any suggestions you have as to how it may be improved are extremely valuable. Please write to the Clinical Governance team at:

Email: [email protected]