Henoch-Schönlein purpura other diagnostic studies: Difference between revisions

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==Other Diagnostic Studies==
==Other Diagnostic Studies==
Biopsy<ref name="pmid9366584">{{cite journal |vauthors=Jennette JC, Falk RJ |title=Small-vessel vasculitis |journal=N. Engl. J. Med. |volume=337 |issue=21 |pages=1512–23 |date=November 1997 |pmid=9366584 |doi=10.1056/NEJM199711203372106 |url=}}</ref><ref name="pmid25557596">{{cite journal |vauthors=Chen JY, Mao JH |title=Henoch-Schönlein purpura nephritis in children: incidence, pathogenesis and management |journal=World J Pediatr |volume=11 |issue=1 |pages=29–34 |date=February 2015 |pmid=25557596 |doi=10.1007/s12519-014-0534-5 |url=}}</ref><ref name="pmid23842510">{{cite journal |vauthors=Kawasaki Y, Ono A, Ohara S, Suzuki Y, Suyama K, Suzuki J, Hosoya M |title=Henoch-Schönlein purpura nephritis in childhood: pathogenesis, prognostic factors and treatment |journal=Fukushima J Med Sci |volume=59 |issue=1 |pages=15–26 |date=2013 |pmid=23842510 |doi= |url=}}</ref>
Biopsy<ref name="pmid9366584">{{cite journal |vauthors=Jennette JC, Falk RJ |title=Small-vessel vasculitis |journal=N. Engl. J. Med. |volume=337 |issue=21 |pages=1512–23 |date=November 1997 |pmid=9366584 |doi=10.1056/NEJM199711203372106 |url=}}</ref><ref name="pmid25557596">{{cite journal |vauthors=Chen JY, Mao JH |title=Henoch-Schönlein purpura nephritis in children: incidence, pathogenesis and management |journal=World J Pediatr |volume=11 |issue=1 |pages=29–34 |date=February 2015 |pmid=25557596 |doi=10.1007/s12519-014-0534-5 |url=}}</ref><ref name="pmid23842510">{{cite journal |vauthors=Kawasaki Y, Ono A, Ohara S, Suzuki Y, Suyama K, Suzuki J, Hosoya M |title=Henoch-Schönlein purpura nephritis in childhood: pathogenesis, prognostic factors and treatment |journal=Fukushima J Med Sci |volume=59 |issue=1 |pages=15–26 |date=2013 |pmid=23842510 |doi= |url=}}</ref>
*Indications
*'''Indications'''
**No rash
**No rash
**Abnormal renal function tests
**Abnormal renal function tests


Skin biopsy
'''Skin biopsy'''
*Light Microscopy
*Light Microscopy
**Classical leukocytoclastic vasculitis in postcapillary venules with IgA deposition is pathognomonic of Henoch-Schönlein purpura.  
**IgA deposition in postcapillary venules with IgA deposition and leukocytoclastic vasculitis in is a pathognomonic microscopic feature of Henoch-Schönlein Purpura.  
**Skin lesions less than 24 hrs are preferred as the chronic lesion lack the immunoglobulin isotypes essential for the diagnosis of HSP.
**Skin lesions less than 24 hrs are preferred as the chronic lesion lack the immunoglobulin isotypes essential for the diagnosis of HSP.
**A biopsy from a different skin site is taken for the Immunofluorescent studies to confirm the diagnosis.
**A biopsy from a different skin site is taken for the immunofluorescent studies to confirm the diagnosis.


Renal biopsy
'''Renal biopsy'''
*IgA deposition in the mesangium on immunofluorescence microscopy should be differentiated from the IgA nephropathy.  
*IgA deposition in the mesangium on immunofluorescence microscopy should be differentiated from the IgA nephropathy.  
*Light microscopic features range from isolated mesangial proliferation to severe crescentic glomerulonephritis.
*Light microscopic features range from isolated mesangial proliferation to severe crescentic glomerulonephritis.

Revision as of 20:18, 7 April 2018

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

Overview

Henoch-Schönlein purpura is diagnosed using a biopsy of the skin and kidney.

Other Diagnostic Studies

Biopsy[1][2][3]

  • Indications
    • No rash
    • Abnormal renal function tests

Skin biopsy

  • Light Microscopy
    • IgA deposition in postcapillary venules with IgA deposition and leukocytoclastic vasculitis in is a pathognomonic microscopic feature of Henoch-Schönlein Purpura.
    • Skin lesions less than 24 hrs are preferred as the chronic lesion lack the immunoglobulin isotypes essential for the diagnosis of HSP.
    • A biopsy from a different skin site is taken for the immunofluorescent studies to confirm the diagnosis.

Renal biopsy

  • IgA deposition in the mesangium on immunofluorescence microscopy should be differentiated from the IgA nephropathy.
  • Light microscopic features range from isolated mesangial proliferation to severe crescentic glomerulonephritis.

References

  1. Jennette JC, Falk RJ (November 1997). "Small-vessel vasculitis". N. Engl. J. Med. 337 (21): 1512–23. doi:10.1056/NEJM199711203372106. PMID 9366584.
  2. Chen JY, Mao JH (February 2015). "Henoch-Schönlein purpura nephritis in children: incidence, pathogenesis and management". World J Pediatr. 11 (1): 29–34. doi:10.1007/s12519-014-0534-5. PMID 25557596.
  3. Kawasaki Y, Ono A, Ohara S, Suzuki Y, Suyama K, Suzuki J, Hosoya M (2013). "Henoch-Schönlein purpura nephritis in childhood: pathogenesis, prognostic factors and treatment". Fukushima J Med Sci. 59 (1): 15–26. PMID 23842510.

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