HSP

Question 1

What is the typical presentation of HSP?

Answer 1

HSP triad:

• 1. Purpuric rash on extensor surfaces of limbs (mainly LL) and buttocks
• 2. Joint pain/swelling
• 3. Abdo pain

Question 2

Commonest age HSP?

Answer 2

2-8y

Question 3

DDx for purpura?

Answer 3

If atypical distribution or child unwell, consider:

• meningococcaemia
• thrombocytopenia
• other rare vasculitides

Question 4

What are the potential serious abdo complications of HSP?

Answer 4

Abdo pain generally resolves in 72h BUT:
- intussusception
- bloody stools
- haematemesis
- spontaneous bowel perfortation
- pancreatitis
All possible complications

Question 5

Features of HSP renal disease?

Answer 5

• haematuria 90%
• only 5% persistent or recurrent
  Less common:
• proteinuria
• nephrotic syndrome
• isolated HTN
• renal insufficiency and failure (below 1%)

Question 6

Ix of HSP?

Answer 6

- UA: MCS if haematuria
Consider:
- FBE
- UEC
- B/C

Question 7

Mx HSP?

Answer 7

• Document BP
• Consider Surg R/V for prominent abdo features (i.e. testicular torsion v testicular vasculitic pain)
• Symptomatic Rx
• Refer GP for BP and Urine review ongoing

Question 8

What are indications for admission in HSP?

Answer 8

• Abdo complication: surg consult
• Renal complication (e.g. nephritis, nephrotic syndrome)
• Symptomatic Rx if severe

Question 9

What is HSP?

Answer 9

Vasculitis of small vessels

Question 10

Common Hx feature HSP?

Answer 10

URTI 1-3w prior to presentation

Question 11

Skin features of HSP on PEx?

Answer 11

• Palpable non thrombocytopenic purpura
• oedema
• scrotal swelling

Question 12

Prongosis HSP?

Answer 12

• self limited, resolves in 4w
• recurrence in ~1/3
• long term depends on severity of nephritis

Question 13

Role of corticosteroids in HSP Mx?

Answer 13

• does not affect renal complication rate
• reduces duration abdo / joint pain
• may reduce risk of abdo complications
  Consider 1mg/kg for more than mild joint or abdo pain