Is there any new information available regarding the treatment of Henoch-Schönlein purpura (HSP)?
—Norma L. Sneed, MD, Checotah, Okla.
HSP is a form of systemic small-vessel vasculitis characterized by vascular and/or mesangial immunoglobulin A1 deposits. The main clinical manifestations are vascular purpura, predominating on the lower limbs, and articular, GI, and renal symptoms. Pulmonary, cardiac, genital, and neurologic symptoms have also been observed. Dapsone has beneficial effects on cutaneous, GI, and articular manifestations in adults, especially those with chronic forms.
Corticosteroids may be useful for refractory abdominal pain. Methylprednisolone pulse therapy, immunosuppressive drugs (e.g., cyclophosphamide and azathioprine), plasma exchange, and polyclonal immunoglobulin therapy are beneficial in very rare life-threatening forms of the disease and, in some cases, when renal function is compromised.
—Jeffrey M. Weinberg, MD (117-20)