Renal: Henoch-Schönlein Purpura: Free MSRA Podcast

🎧 FREE MSRA PODCAST – Henoch-Schönlein Purpura (HSP): The Classic Childhood VasculitisRevision overload? We break down HSP into the core clinical, diagnostic, and management essentials—perfect for MSRA and UK practice. Tetrads, triggers, complications, and what NOT to miss!🧠 Key Learning PointsDefinition• HSP = IgA-mediated small vessel vasculitis, mostly in children.• Affects: Skin, GI tract, joints, kidneys.Classic TetradPalpable purpura (non-blanching rash, typically lower limbs & buttocks)Abdominal pain (may include GI bleeding, diarrhoea)Arthralgia/arthritis (joint pain/swelling, especially knees/ankles)Renal involvement (haematuria, proteinuria, rarely nephritic/nephrotic syndrome)Causes & Triggers• Often follows upper respiratory tract infection• Other triggers: Medications, vaccinations, insect bites, various infections (Strep, EBV, Mycoplasma, Parvovirus B19, Coxsackie, Campylobacter, Varicella, Adenovirus)• Rarely: Malignancy (especially adults)Pathophysiology• IgA immune complexes deposit in small vessel walls, activating complement → inflammation, increased permeability• Leads to tissue damage in skin, joints, GI tract, kidneysDifferential Diagnosis• Intussusception (as both complication & mimic)• SLE/other connective tissue diseases• Thrombocytopenia, meningococcal sepsis• Other causes of glomerulonephritis or purpura• Acute haemorrhagic oedema of infancyEpidemiology (UK)• Most common systemic vasculitis in children• Peak: Ages 2–11 (esp. 4–6), slight male preponderance• 10–20 per 100,000 children/year• Seasonal: Winter/Spring (links to URTIs)Clinical Features• Preceding URTI common• Rash: Palpable, non-blanching, lower limbs/buttocks• Joint pain/swelling• Abdominal pain, GI bleeding• Renal: Haematuria, proteinuria• May see: Low-grade fever, scrotal swelling, rare CNS symptomsDiagnosis• Clinical diagnosis (no single diagnostic test)• Labs: Urinalysis (haematuria, proteinuria), FBC (normal/increased platelets), ESR (raised), serum creatinine (for renal function), IgA (often ↑ but non-specific), autoantibody screen (exclude SLE)• Imaging: Abdominal USS for severe pain or suspected intussusception, testicular USS if scrotal symptoms• Renal biopsy: If persistent/severe renal involvementManagement• Mostly supportive: Paracetamol for pain, hydration, wound care• NSAIDs with caution—avoid if GI/renal involvement• Hospitalisation for severe pain, GI bleeding, or renal issues• Steroids: May help pain, but not routinely for preventing/treating renal involvement in children• Plasma exchange: Only in severe adult nephritis (not standard)Prognosis & Complications• Most recover fully, self-limiting (weeks–months)• Renal involvement in up to 55%: Usually mild, rarely ESRD (<1%)• Other: GI bleed, intussusception, testicular haemorrhage/torsion, CNS events (all rare)• Recurrence in ~1/3 (esp. within 6 months)• Follow-up essential: BP and urinalysis for delayed/ongoing renal issuesMemory Aid:HSP = “IgA Purpura in Kids, Kidneys, Knees, and Gut”📎 More HSP Revision Resources:📝 Revision Notes: https://www.passthemsra.com/topic/henoch-schonlein-purpura-revision-notes/💬 Flashcards: https://www.passthemsra.com/topic/henoch-schonlein-purpura-flashcards-2/🧠 Q&A Notes: https://www.passthemsra.com/topic/henoch-schonlein-purpura-accordion-qa-notes-2/📝 Rapid Quiz: https://www.passthemsra.com/topic/henoch-schonlein-purpura-rapid-quiz-2/🎯 Quiz Portal: https://www.passthemsra.com/quizzes/henoch-schonlein-purpura-2/📚 Renal Course: https://www.passthemsra.com/courses/renal-for-the-msra/🏷️ #MSRA #HenochSchönleinPurpura #HSP #Vasculitis #Paediatrics #MSRARevision #MSRAFlashcards #MSRAQuiz #PassTheMSRA #FreeMSRA #Renal #SmallVesselVasculitis #Purpura #PaediatricNephrology #KidneyHealth #ChildrensHealth