Clinical Reference Systems: Pediatric Advisor 10.0

Description

Anaphylactoid purpura (also called Henoch-Schoenlein purpura) is an illness that can involve many different organs in the body.

The cause of this illness is not completely understood. Researchers believe that there is some inflammation (swelling) in the blood vessels, which causes symptoms. The illness is often seen in children who have had a viral upper respiratory infection (a cold) a few weeks earlier. The antibodies produced by the child's body to fight the cold may contribute to development of the illness.

Symptoms

Anaphylactoid purpura can occur with some or all of the following symptoms:

• Rash: The rash is often located on the buttocks and legs. The rash may first look like hives, but usually it changes to purplish or brownish bruises within 1 to 2 days. There is always some rash on the ankles.
• Painful swelling of the joints: The joints most often affected by pain are the knees and ankles. The joint pain may be severe enough to make you child unable or unwilling to walk.
• Abdominal pain: If your child has severe abdominal pain or blood in his or her stools, the doctor may need to do tests to rule out other, more serious causes of these symptoms.
• Fever
• Blood in the urine.

Home Care

There is no medicine that can cure this illness. There is also no way known to predict who will get anaphylactoid purpura and there is no way to prevent it. The illness may last for several months and the symptoms may come and go during this time. The older your child is, the more likely it is that he or she will experience the symptoms again. Your child will eventually get better on his or her own. Until then, you can treat your child's symptoms.

1. Anti-inflammatory medications

   The best and safest medication to give to help with the pain and inflammation of swollen joints is ibuprofen (for example, Advil or Motrin). Use the same dose you use to treat your child's fever. Do not use aspirin. Acetaminophen (for example, Tylenol) may help with the pain, but it will not relieve swelling and inflammation.

2. Steroid medications

   Your child's doctor may prescribe a steroid medication, such as prednisone, to reduce inflammation in the intestine. The steroid may help control pain and intestinal bleeding.

3. Fluids

   Encourage your child to drink plenty of fluids and to eat a normal diet as much as is possible.

Follow-Up

Most children recover from anaphylactoid purpura completely and have no further problems. Rarely, however, the kidneys can be affected. It is important for your child to see a doctor for blood pressure checks and urine tests every 1 to 2 months over the next 2 years.

Call Your Child's Physician IMMEDIATELY If:

• Your child develops a fever and the purplish rash.
• Your child's abdominal pain is getting more severe, or there is more blood in your child's bowel movements.
• Your child is refusing to eat or drink.
• Your child has not urinated in over 12 hours.
• Your child begins to look puffy, especially around the face or eyes.
• Your child's urine has blood in it.
• Your child is acting very sick.

Call Your Child's Physician During Office Hours If:

• You have other questions or concerns.