Henoch-Schönlein purpura laboratory findings: Difference between revisions

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==Overview==
==Overview==
There is no specific diagnostic test available for HSP. Platelet count, [[coagulation]] studies such as [[PT]], [[aPTT]], and [[Bleeding time|BT]] are done to rule out other diseases like [[coagulopathies]]. They are usually normal. [[Urinalysis]] is done to check for any blood in the urine or [[proteinuria]] for renal involvement. Serum [[IgA]] levels are elevated in the majority of patients with HSP, and in patients with [[renal]] involvement higher [[IgA]] levels are detected.


==Laboratory findings==
==Laboratory findings==
The diagnosis is based on the combination of the symptoms, as very few other diseases cause the same symptoms together.  [[Blood test]]s may show elevated [[creatinine]] and [[urea]] levels (in kidney involvement), raised [[IgA]] levels (in about 50%), and raised [[C-reactive protein]] (CRP) or [[erythrocyte sedimentation rate]] (ESR) results; none are specific for Henoch-Schönlein purpura. The [[platelet]] count may be raised, and distinguishes the purpura from diseases in which the low platelets are the cause of the purpura ([[idiopathic thrombocytopenic purpura]], [[thrombotic thrombocytopenic purpura]]).
*Laboratory findings of HSP:<ref name="pmid11552081">{{cite journal |vauthors=Calviño MC, Llorca J, García-Porrúa C, Fernández-Iglesias JL, Rodriguez-Ledo P, González-Gay MA |title=Henoch-Schönlein purpura in children from northwestern Spain: a 20-year epidemiologic and clinical study |journal=Medicine (Baltimore) |volume=80 |issue=5 |pages=279–90 |date=September 2001 |pmid=11552081 |doi= |url=}}</ref><ref name="pmid5003905">{{cite journal |vauthors=Trygstad CW, Stiehm ER |title=Elevated serum IgA globulin in anaphylactoid purpura |journal=Pediatrics |volume=47 |issue=6 |pages=1023–8 |date=June 1971 |pmid=5003905 |doi= |url=}}</ref><ref name="pmid11231337">{{cite journal |vauthors=Davin JC, Ten Berge IJ, Weening JJ |title=What is the difference between IgA nephropathy and Henoch-Schönlein purpura nephritis? |journal=Kidney Int. |volume=59 |issue=3 |pages=823–34 |date=March 2001 |pmid=11231337 |doi=10.1046/j.1523-1755.2001.059003823.x |url=}}</ref><ref name="pmid22271365">{{cite journal |vauthors=Lin Q, Min Y, Li Y, Zhu Y, Song X, Xu Q, Wang L, Cheng J, Feng Q, Li X |title=Henoch-Schönlein purpura with hypocomplementemia |journal=Pediatr. Nephrol. |volume=27 |issue=5 |pages=801–6 |date=May 2012 |pmid=22271365 |doi=10.1007/s00467-011-2070-z |url=}}</ref>
===Renal disease===
*There is no specific diagnostic test available for HSP.
Of the 40% of patients who develop kidney involvement, almost all have evidence (visible or on [[urinalysis]]) of blood in the urine. More than half also have [[proteinuria]] (protein in the urine), which in one eighth is severe enough to cause [[nephrotic syndrome]] (generalised swelling due to low protein content of the blood). While abnormalities on urinalysis may continue for a long time, only 1% of all HSP patients develop [[chronic kidney disease]]. [[Hypertension]] (high blood pressure) may occur. Protein loss and high blood pressure, as well as the features on [[biopsy]] of the kidney if performed, may predict progression to advanced kidney disease. Adults are more likely than children to develop advanced kidney disease.<ref name=Shrestha2006>{{cite journal |author=Shrestha S, Sumingan N, Tan J, ''et al'' |title=Henoch Schönlein purpura with nephritis in adults: adverse prognostic indicators in a UK population |journal=QJM |volume=99 |issue=4 |pages=253–65 |year=2006 |pmid=16565522|doi=10.1093/qjmed/hcl034| url=http://qjmed.oxfordjournals.org/cgi/content/full/99/4/253}}</ref>
*[[Platelet count]], [[coagulation studies]] such as [[PT]], [[aPTT]], and BT is done to rule out other diseases like [[coagulopathies]]. They are usually normal.
*[[Urinalysis]], is done to check for any blood in the urine or [[proteinuria]] for renal involvement.
*Serum [[IgA]] levels are elevated in the majority of patients with HSP, and in patients with [[renal]] involvement higher [[IgA]] levels are detected.
*The routine blood tests [[CBC]] (complete blood count), [[metabolic profile]], [[urinalysis]] are usually inconclusive.
*Patients with occult [[Gastrointestinal bleeding|GI bleeding]] may have anemia.  
*Since HSP is a type-III [[hypersensitivity]] reaction complements are consumed by the [[immune complexes]] eventually leading to [[hypocomplementemia]] (decreased C3 and C4).
*[[Leukocytosis]] and elevated acute phase reactants are noted in patients with HSP secondary to [[bacterial]] infections.  


==References==
==References==


{{reflist|2}}
{{reflist|2}}
[[Category:Disease]]
[[Category:Rheumatology]]
[[Category:Pediatrics]]
[[Category:Nephrology]]
[[Category:Autoimmune diseases]]
[[Category:Hematology]]
[[Category:Mature chapter]]


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Latest revision as of 20:33, 15 April 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

There is no specific diagnostic test available for HSP. Platelet count, coagulation studies such as PT, aPTT, and BT are done to rule out other diseases like coagulopathies. They are usually normal. Urinalysis is done to check for any blood in the urine or proteinuria for renal involvement. Serum IgA levels are elevated in the majority of patients with HSP, and in patients with renal involvement higher IgA levels are detected.

Laboratory findings

References

  1. Calviño MC, Llorca J, García-Porrúa C, Fernández-Iglesias JL, Rodriguez-Ledo P, González-Gay MA (September 2001). "Henoch-Schönlein purpura in children from northwestern Spain: a 20-year epidemiologic and clinical study". Medicine (Baltimore). 80 (5): 279–90. PMID 11552081.
  2. Trygstad CW, Stiehm ER (June 1971). "Elevated serum IgA globulin in anaphylactoid purpura". Pediatrics. 47 (6): 1023–8. PMID 5003905.
  3. Davin JC, Ten Berge IJ, Weening JJ (March 2001). "What is the difference between IgA nephropathy and Henoch-Schönlein purpura nephritis?". Kidney Int. 59 (3): 823–34. doi:10.1046/j.1523-1755.2001.059003823.x. PMID 11231337.
  4. Lin Q, Min Y, Li Y, Zhu Y, Song X, Xu Q, Wang L, Cheng J, Feng Q, Li X (May 2012). "Henoch-Schönlein purpura with hypocomplementemia". Pediatr. Nephrol. 27 (5): 801–6. doi:10.1007/s00467-011-2070-z. PMID 22271365.

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