Henoch-Schönlein Purpura (HSP)

What is HSP?

Henoch-Schönlein Purpura (HSP) is a condition where small blood vessels in the body (particularly in the skin, intestines and kidneys) become irritated and swollen. This is called vasculitis and it is commonly seen in children aged two to eight years. It is characterised by a rash, called purpura, which looks like bruising. This rash may not always be visible right away. Blood vessels in the skin, intestines and kidneys are often affected.

HSP is often triggered by viral illnesses such as a cold or flu, but it isn’t contagious and cannot be passed on to other people.

Signs and symptoms

  • Raised rash with reddish-purple spots on the buttocks, legs and elbows.
  • Swollen hands and feet.
  • Joint pain (usually in the knees or ankles).
  • Abdominal pain.
  • Blood or protein in stools or urine.

How is it diagnosed?

There is no test for HSP, so it is normally diagnosed by a doctor looking at the rash on the skin and asking about other symptoms.

Your doctor will take your child’s blood pressure and order a urine test to check for protein and blood in the urine. They may also do a blood test to check the kidneys.

Mild pain Moderate pain Severe pain
  • Give pain medication
  • Rest
  • Elevate the legs
  • Mild treatment +
  • Steroid therapy may be needed
    (talk to your GP about this treatment option)
  • Moderate treatment +
  • Further testing and hospital
    admission may be needed

Care at home

  • Most children will recover from HSP within four weeks, with joint pain easing after the first three days. It is common for symptoms to come back within the first few months in about a third of children, however these episodes tend to be
    less severe.
  • Make sure your child drinks enough fluids including water.
  • Give paracetamol (Panadol) and/or ibuprofen (Nurofen) to help relieve pain. Follow the dosage directions on the packaging and do not give more than the maximum recommended doses in a day for your child’s age.
  • Your child will need regular check-ups with your GP for 12 months, including urine tests and blood pressure checks. This is to make sure they do not develop kidney problems. See appointment schedule below.
  • Please make an appointment with your doctor to start these regular check-ups as soon as your child has been diagnosed with HSP.
  • If your child has kidney problems after three months, your doctor will refer them to a specialist.

Appointment schedule Completed
Week 1
Week 2
Week 3
Week 4
Week 6
Week 8
Week 10
Week 12
(your child will be referred to a specialist if kidney problems are detected)
6 months
9 months
12 months and then yearly

When should I see a doctor?

Your child should see a GP for regular check-ups for 6 to 12 months after being diagnosed with HSP (see appointment schedule above).

You should see your GP if treatment is not working as expected, you have concerns about your child’s health, or your child is experiencing any of the following:

  • increasing joint pain or swelling
  • increasing abdominal pain
  • blood in stools or urine.

In an emergency, always call 000 immediately. Otherwise, contact your local doctor or visit the emergency department of your nearest hospital. For non-urgent medical advice, call 13 HEALTH (13 43 25 84) to speak to a registered nurse 24 hours a day, seven days a week for the cost of a local call.

Things to remember

  • HSP causes inflammation of the small blood vessels in the skin, kidneys and intestines.
  • It usually gets better without treatment within 4 weeks.
  • Paracetamol and ibuprofen can be given for pain relief.
  • See a doctor urgently if your child has worsening pain, swelling, blood in stool or urine, or if you have any concerns.
  • Your child will need regular check-ups after they have recovered from HSP to make sure they do not develop kidney problems.

Resource No: FS214. Developed by Emergency, Queensland Children’s Hospital. Updated: December 2020.

All information contained in this sheet has been supplied by qualified professionals as a guideline for care only. Seek medical advice, as appropriate, for concerns regarding your child’s health.

CHQ