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Purpura Schönlein-Henoch

Häufigste Vaskulitis des Kindes- und Jugendalters

Henoch-Schönlein purpura

Most frequent form of vasculitis in childhood and adolescence

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Zusammenfassung

Die Purpura Schönlein-Henoch ist die häufigste Vaskulitis im Kindes- und Jugendalter. Sie manifestiert sich mit einer palpablen Purpura im Bereich der lageabhängigen Extremitäten bei klinisch gutem Allgemeinbefinden. Allerdings kann der Hautbefund variabel sein, sodass manchmal andere Differenzialdiagnosen erwogen werden müssen. Extrakutane Manifestationen sind häufig und können der Purpura vorangehen. Im typischen Fall kann auf eine ausgedehnte Diagnostik verzichtet werden, allerdings sollten die kurzfristigen Komplikationen einer abdominellen Beteiligung wie auch die langfristigen Komplikationen einer Nephritis verfolgt werden. Bei muskuloskelettalen Symptomen sind Paracetamol oder nichtsteroidale Antiphlogistika wirksam, zur Verkürzung der Dauer bei Bauchschmerzen Steroide. Die Wirksamkeit einer Steroidpropyhlaxe von renalen Schäden ist weiterhin kontrovers.

Abstract

Henoch-Schönlein purpura is the most common form of vasculitis in childhood and adolescence. It is manifested as palpable purpuras in the region of position-dependent extremities with otherwise good clinical general condition. The expression on the skin can, however, be variable so that sometimes other differential diagnoses must be included. In typical cases an extensive diagnostic procedure is unnecessary but the short-term complications of abdominal symptoms as well as the long-term complications of nephritis should be pursued. If musculoskeletal symptoms occur paracetamol or non-steroidal anti-inflammatory drugs are effective as are steroids for reducing the duration of abdominal pain. The effectiveness of steroid prophylaxis of renal damage is still controversial.

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Hospach, T., Huppertz, HI. Purpura Schönlein-Henoch. Z. Rheumatol. 70, 829–837 (2011). https://doi.org/10.1007/s00393-011-0800-z

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