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Originally Posted by autowreckers How do we follow up a child with HSP?
Any one with good answer? |
autowreckers its a very good discussion, follow up for the HSP needed to rule out the renal impairment.
Lets get back to its Pathophysiology: HSP is a small-vessel vasculitis characterized by immunoglobulin A (IgA), C3, and immune complex deposition in arterioles, capillaries, and venules. HSP and IgA nephropathy are related disorders. Both illnesses have elevated serum IgA levels and identical findings on renal biopsy; however, IgA nephropathy almost exclusively involves young adults and predominantly affects the kidneys only. HSP affects mostly children and involves the skin and connective tissues, gastrointestinal tract, joints, and scrotum as well as the kidneys.
Prognosis:
- HSP is generally a benign disease with an excellent prognosis.
- More than 80% of patients have a single isolated episode lasting a few weeks.
- Approximately 10-20% of patients have recurrences.
- Fewer than 5% of patients develop chronic HSP.
- Abdominal pain resolves spontaneously within 72 hours in most patients.
Therefore the duration of follow up to assess the risk of long term renal impairment in Henoch-Schonlein purpura (HSP) without nephritic or nephrotic syndrome or renal failure on diagnosis remains undetermined.
HSP should have urinalysis and blood pressure measurements at diagnosis and with each recurrence. If hematuria and/or proteinuria are discovered, serum urea and creatinine levels should be followed for up to 6 months after diagnosis. Follow-up beyond 6 months is required for those with continued isolated hematuria or proteinuria. If nephrotic syndrome or nephritis appears, immediate pediatric nephrology consultation is warranted, and continued long-term follow-up is appropriate.