What is HSP?

Symptoms of HSP can vary greatly from person to person. Some patients get all of these symptoms, some get only one or two, and a small number are asymptomatic completely. Even in patients who experience most or all of the effects of HSP, each individual symptom can wax and wane over the course of the disease, making it sometimes difficult even for physicians to correctly diagnose HSP, in certain cases.

Consider: a child is brought into a pediatrician’s office complaining of belly pain. After a few routine questions and examinations with no unusual results, the physician (quite reasonably) might initially diagnose some sort of stomach virus. It is only when the child comes back in four or five days or a week (or more) with the telltale rash-like symptoms that a correct diagnosis is made. Here are the major (observable) symptoms of HSP (pull-down menu):

• Purpura

From the Latin, purpura* is the appearance of red or purple discolorations on the skin, caused by bleeding underneath the skin. It can show up as bright red spots or broader bruising. The spots are usually raised and palpable - you can feel them. Often the purpura starts around the feet and ankles and moves upwards, focusing on the legs, buttocks, lower back and arms. It is much less common to find purpura on the face or torso.

* meaning
"purple"...go figure, LOL...

• Joint pain

Patients can develop arthritis-like pain in their joints, again starting with ankles and moving up to knees, hips, elbows and wrists. This pain can be debilitating, but often seems to disappear. Or, it can appear in certain joints, then resolve in those joints and reappear in other areas days, sometimes weeks, later.

• Stomach pain

This can be very severe in some patients. It is caused by capillaries in the stomach wall/lining leaking blood, which makes the stomach/bowel wall inflamed and irritated. The blood can cause the patient's stool to look very dark (from blood high up in the GI tract), or it can be brighter red (if the bleeding is lower in the intestines). It can also appear in the patients vomitus if he or she is vomiting. Seeing blood like that can be a cause for panic, but remember that this is probably part of the disease, not some additional malady. That's not to say that a patient couldn't also have something additional wrong with their stomach or GI tract, just that this blood is considered a common symptom of HSP. HSP patients may also vomit bile if the gallbladder and biliary tract become involved.

• Nausea

Caused by inflammation and irritation of the GI tract. It can lead to severe vomiting with dehydration. Unfortunately, if the patient suffers from this, it can hamper absorption of meds, leading to even more irritation, less absorption of meds, etc. IV fluids and anti-nausea medication can be very helpful.

• Fatigue

Many patients report feeling completely worn out and weak. Since HSP is a systemic issue, the entire body is essentially fighting with itself, leading to overwhelming exhaustion. On days when the patient feels better, they may try to do too much, causing a deterioration on subsequent days.

There may be other secondary symptoms from HSP related to some of the primary issues - vision may be affected by swelling in the capillaries in the eyes, patients may bruise very easily, blood pressure can be affected. Male patients may experience pain and swelling of the testicles, sometimes leading to testicular torsion (“twisting” of the testicles).

If you or your child have these symptoms, you should discuss HSP with your doctor to confirm or rule out a diagnosis.