HENOCH-SCHÖNLEIN PURPURA (HSP)

Key words: Henoch-Schönlein purpura, Nephritis, Corticosteroids, Overview

Henoch-Schönlein purpura (HSP) is the most common vasculitic disease of childhood. HSP is a multisystem immunoglobulin A-mediated vasculitis with a self-limited course usually affecting the skin, joints, gastrointestinal tract, and kidneys. HSP occurs most often in children before the age of 10 years, and classically presents with a unique distribution of the rash to the lower extremities and the buttocks. One third of these patients will have one or more recurrences of symptoms, usually within 6 weeks, but they may occur as late as 18 months later. The overall prognosis in HSP is excellent, but the long-term morbidity depends mainly on the renal involvement. In our opinion, actually, there are no data to recommend the routine use of corticosteroids in the management of uncomplicated HSP, in both the acute and chronic settings.