From the Guidelines
Henoch-Schönlein Purpura (HSP) in adults is a condition with a worse prognosis compared to children, characterized by severe initial renal involvement and risk of progression, particularly with protein excretion of 1 g/d or more. The causes of HSP in adults are not well understood, but it is thought to be related to immune complex deposition and inflammation, similar to the pathophysiology in children 1. Symptoms of HSP in adults may include:
- Purpura, which is the most common symptom
- Arthritis or arthralgia
- Abdominal pain
- Gastrointestinal bleeding
- Renal involvement, which can range from mild hematuria to severe nephritis or nephrotic syndrome
The approach to treatment in adults with HSP is similar to that in children, although the long-term benefit of steroid therapy for nephrotic-range or persistent proteinuria, or intravenous corticosteroids and other immunosuppressive agents for crescentic HSP, has not been proven 1. It is essential to monitor kidney function, blood counts, and other clinical factors closely to guide treatment decisions.
Key factors that influence the prognosis and treatment of HSP in adults include:
- Severity of renal involvement
- Level of protein excretion
- Presence of other clinical factors that may confound the data, such as comorbidities or underlying health conditions
- Response to treatment, particularly steroid therapy or immunosuppressive agents.
From the Research
Causes of Henoch-Schönlein Purpura (HSP) in Adults
There are no research papers provided to directly answer the question about the causes and symptoms of Henoch-Schönlein Purpura (HSP) in adults. The studies provided are related to Hemolytic Uremic Syndrome (HUS), which is a different condition.
Symptoms of HUS
Although the question is about HSP, the provided studies discuss HUS, which has the following symptoms:
- Nonimmune haemolytic anaemia
- Thrombocytopenia
- Acute renal failure
- Hemolysis
- Thrombotic microangiopathy 2, 3, 4, 5
- Schistocytes (red blood cell fragments) consistent with microangiopathic hemolytic anemia 6
Causes of HUS
The causes of HUS mentioned in the studies include:
- Infection with Shiga toxin-producing Escherichia coli (STEC) 2, 3, 5
- Atypical HUS due to complement dysregulation caused by mutations or autoantibodies 3, 4, 5
- Postoperative atypical HUS 6
- Pregnancy or kidney transplantation 2
- Certain medications such as mitomycin C, gemcitabine, ciclosporin A, or tacrolimus, and bevacizumab, an anti VEGF antibody 3