Tuesday, November 18, 2008

henoch schonlein purpura (HSP)

doing paeds here is spectacular. met a girl with HOCM but her main concern at the moment is IDDM. then saw a chap with HSP.

so, here are some random facts about HSP.
  • usually patients get it following a URTI
  • initially present with macula papular, non blanching rash, affecting the buttock, legs, feet, but trunk sparing. but rash cann appear blotchy & with a bruised appearance too
  • abd pain.
  • joint pain typically affecting the larger joints such as the hip, knee. there may be swelling of the joints.
  • microscopic haematuria. so if the patients comes with frank haematuria, then more likely not to be HSP
  • treatment is symptomatic. have to monitor for renal function. so do a msu, 24H urine collection, spot on protein: creatinine ratio, U&E + measure BP as well. if no sequalle for the next 6 months, then renal dysfunction is unlikely.
differentials: ITP, allergic rxn, viral infection.