HENOCH-SCHÖNLEIN PURPURA

RAVANIA RAHADIAN PUTRI

VASCULAR PURPURA

• Purpura merupakan suatu manifestasi klinis dari ekstravasasi eritrosit

(perdarahan) menuju mukosa atau kulit yang merupakan hasil dari berbagai
kondisi, termasuk rheumatologic, infeksius, dermatologic, traumatic, dan
kelainan hematologic.
NON-THROMBOCYTOPENIC PURPURA

1) Palpable or retiform and noninflammatory, such as

hyperglobulinemic purpura of Waldenström,

2) Palpable or nonpalpable but inflammatory, such as

Henoch-Schönlein purpura

3) Nonpalpable and noninflammatory, such as

senile purpura.
DEFINISI

Henoch-Schönlein Purpura/Allergic purpura/ Anaphylactoid merupakan

sindrom vasculitis (Non-Thrombocytopenic Purpura) yang umumnya menyerang
anak-anak, ditandai dengan adanya nyeri abdominal akut, plak urtikaria pada
ekstremitas bawah dan “palpable purpura”.
EPIDEMIOLOGI

• Sering menyerang anak-anak pada usia 3-7 tahun

• Jarang menyerang usia <2 dan >20 tahun
• Menyerang lebih banyak pada anak laki-laki, l:p (2:1)
• Menyerang sama pada dewasa pria dan wanita
• Sering muncul bersamaan dengan Infeksi Saluran Pernapasan Atas (ISPA)
ETIOLOGI

• The etiology remais unclear, many environmental • It has been suggested that allergic purpura (HSP)
triggers: may represent autoimmunity to components of
vessel wall
- viral (hepatitis B virus, HCV, parvovirus B19, HIV)
- bacterial (Streptococcus species, S. aureus,
Salmonella species) infections in children
- medications (nonsteroidal antiinflammatory drugs
[NSAIDs], angiotensin-converting enzyme inhibitors,
antibiotics)
- food allergies
- insect bites in adults.
GX KLINIS
• KULIT: • SENDI • RENAL
- Petechiae - Transient - Microscopic hematuria

- Purpura - Oligoarthricular - Proteinuria

Palpable purpura
- Urticaria - Non- Deforming - Hypertension
- Itching • GI - Nephritis

- Abdominal pain - Nephrotic syndrome

• Malaise - Diarrhea - Renal failure

• Headache - Vomiting
• Fever - Hematochezia
- Intussception
LABORATORY TEST INDICATION
Antistreptolysin-O titers Previous streptococcal infection implicated as predisposing
factor in many patients
Basic metabolic panel (e.g., electrolytes, blood urea Monitor for renal insufficiency or failure
nitrogen, creatinine) Electrolyte imbalance may exist in patients with significant
gastrointestinal involvement
Blood culture Evaluate for bacteremia or sepsis as possible cause

Coagulation profile (PT/aPTT) Evaluate for bleeding diathesis

Complete blood count Thrombocytopenia suggests alternate diagnosis
Evaluate for anemia because of risk of gastrointestinal
bleeding
Mild leukocytosis typically seen with Henoch-Schönlein
purpura
IgA levels Elevated IgA levels support diagnosis of Henoch-Schönlein
purpura over other forms of leukocytoclastic vasculitis, but is
nonspecific
Skin or renal biopsy Assess for IgA deposition to assist in diagnosis
Aid in prognosis in patients with renal involvement

Urinalysis Assess for renal involvement (microscopic or gross

hematuria, with or without proteinuria)
TATA LAKSANA

• Umumnya pasien dapat sembuh tanpa pengobatan

• Immunosupresive drugs (e.g/ glukokortikoid)  jika terdapat gangguan
ginjal
• Kortikosteroid  untuk mengurangi gejala inflamasi (tidak efektif)
• Follow up 6 bulan sekali ( tek. Darah, urinalisis)