Henoch-Schönlein purpura (HSP)

Henoch-Schönlein purpura (HSP) affects the blood vessels and causes a spotty rash, usually in children. It's not usually serious, but can sometimes lead to kidney problems. You should always get medical advice for a diagnosis, if the rash appears.

Symptoms of HSP

A total of 90 per cent of cases occur in childhood, most commonly in children aged 4-6 years. It is rare in infants and young children.

The main symptom of HSP is a rash of raised red or purple spots. The spots look like small bruises or blood spots.

The rash usually appears on the legs or bottom. There may be lots of spots or just a few. You may also have pain in your knees, ankles or tummy.

Sometimes there can be blood in your child’s pee or poo. If the kidneys are affected there can be a build-up of fluid causing swelling in the feet and legs.

When to get medical help

Ask for an urgent GP appointment or contact GP out of hours service for advice if:

  • you or your child have a rash that doesn't fade when a glass is pressed against it (glass test) – but you don't feel unwell

This could be HSP.

Call 999 or go to your nearest emergency department immediately if:

  • a rash doesn't fade when a glass is pressed against it and you or your child feel very unwell – for example, it's painful to look at bright lights or you have a stiff neck, (see glass test below)

This could be something serious like meningitis.

How to do the glass test

To do the glass test:

  • press the side of a clear glass firmly against the skin
  • check a few times to see if you can still see the spots through the glass – that is the rash doesn’t fade when the glass is pressed against it

The rash can be hard to see on dark skin. Check paler areas like the palms of the hands and the soles of the feet.

What happens with HSP

Tests will probably be needed to check if the kidneys are affected. There's no treatment for HSP. It usually passes in a few weeks normally with just rest at home until feeling better.

HSP can't spread to others, so:

  • your child can return to school or nursery when they feel well enough
  • you can go back to work as soon as you feel up to it

Treatment to relieve symptoms

Paracetamol can help ease any pain. Don't take ibuprofen without speaking to your doctor because it could harm your kidneys.

Regular check-ups for kidney problems

If you or your child were diagnosed with having had HSP, you'll have regular check-ups for 6 to 12 months to check how well your kidneys are working.

You'll usually be asked to provide a sample of pee and have your blood pressure checked at each appointment. This may be done at home, at your GP surgery, or in hospital.

Treatment in hospital

You may need to be admitted to hospital if HSP affects your kidneys.

In hospital, you may be given strong medicines like steroids to help ease your symptoms.

Long-lasting effects of HSP

Most people with HSP make a full recovery. Any kidney problems usually get better without treatment.

But sometimes HSP can be severe and last several months, particularly in adults.

There's also a small chance the kidneys could be permanently damaged (chronic kidney disease). This is why it's important to have regular check-ups.

You can get HSP more than once. Get medical advice quickly if the symptoms come back.

The information on this page has been adapted from original content from the NHS website.

For further information see terms and conditions.

This page was published July 2018

This page is due for review January 2021

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