The following symptoms and complaints may indicate the presence of Schönlein-Henoch purpura:
The diagnosis is classically made in the presence of the following symptom triad.
- Hemorrhagic exanthema (“bleeding rash”)/palpable (palpable) petechiae or purpura/ (see skin below) [obligatory!].
- Arthritis (inflammation of the joints)
- Colicky abdominal pain (angina abdominalis)
The five most common manifestations are:
1. skin (100%)
- Hemorrhagic exanthema:
- Onset: 0.1-5.0 cm bright red spots.
- Later: maculo-papular, red, or red-blue, to blue-black papules (nodular change on skin) and plaques (above the skin level elevating, “plate-like” substance proliferation of the skin ) (palpable (palpable) petechiae (punctate bleeding of the skin or mucous membrane in the form of a capillary hemorrhage) or palpable purpura) (spontaneous, small-spotted skin, subcutaneous or mucous membrane bleeding).
- With increasing duration: brown-yellow discoloration of the exanthema.
- Preferred region: extensor side of legs and buttocks; rarely upper extremity, face and trunk.
Recovery: after about 2-3 weeksTotal duration: about 3-16 weeks.
2. joints (50-75%)
- Arthritis (inflammation of the joints); often affected are the knee and ankle joints; occurs partly suddenly.
3. gastrointestinal tract (gastrointestinal tract) (50-75%).
- Colicky abdominal pain (angina abdominalis).
- Emesis (vomiting)
- Gastrointestinal bleeding (bleeding in the gastrointestinal tract) with melena (blood in the stool)
- Invagination (invagination of a part of the intestine into the aborally following part of the intestine) (0.7-13.5% of cases) – localization: ileoileal/area of Bauhin’s valve/ileocecal valve (50%), followed by ileocolic invagination/ileal (scum, lower part of the small intestine) into the colon (large intestine) (40%)
4. kidneys (5-50-90%)
- Hematuria (blood in the urine).
- Histologically (fine tissue): mesangioproliferative glomerulonephritis with mesangial IgA deposits.
- Proteinuria (increased excretion of protein in the urine).
5. central nervous system (10-30%).
- Cephalgia (headache)
- Behavioral disorders
- Pathological EEG
General symptoms
- Fever
- Severe feeling of illness
According to the ACR* criteria, Schönlein-Henoch purpura is considered established when two of the following criteria four criteria are met:
- Palpable (palpable) purpura
- Age of manifestation <20 years
- Intestinal colic
- Histological evidence of granulocytes (belonging to the white blood cells) in the vascular wall of arterioles (small arteries located behind the arteries and in front of the capillaries in the bloodstream)
* American College of Rheumatology (ACR)
