Differential Diagnosis of HSP

• Chron’s Disease  No palpable purpura

• Wegener’s Granulomatosis
• Infective Endocarditis
• IgA Nephropathy  No palpable Purpura
• Hemolytics Uremic Syndrome
• Hypersensitivity Vasculitis  palpable purpura, rarely gastrointertinal-
tract manifestation, No IgA deposition
Differential Diagnosis HSP
Differential Diagnosis HSP
Treatment of HSP
• HSP is self-limiting in 94% children and 89% adults
• Symptomatic treatment for symptoms such as rash and arthritis. Acetaminophen and NSAIDs can be used.
• Avoid aspirin in children
• Early steroid therapy decreases GI Symptoms: 12.3 days  2 days; decrease HSP / GI recurrence; and
reduce renal progression
• Steroid may prevent major complication such as GI bleeding or intussusception
• High-dose IV pulse steroid (pulse doses range from 500mg to 1gr)
• Immunosuppressive drugs (cyclophosphamide, azathioprine, cyclosporine A, and mycophenolate mofetil)
in combination with high-dose IV pulse steroids are recommended if there is no benefit from steroids
alone
• Plasmapheresis or high-dose intravenous immunoglobulin therapy may be recommended for worsening
renal function, and hemorrhage in the lungs and brain refractory to steroids and immunosuppressive
drugs.
• Dapsone or colchicine may be useful in chronic HSP
Treatment of HSP