II. Epidemiology

  1. Incidence
    1. Children: 3 to 26 (mean 14) in 100,000
    2. Adults: 0.8 to 1.8 in 100,000
  2. Age
    1. Children aged 2-11 years represent 75-90% of cases
      1. HSP is the most common acute Vasculitis in children
      2. Peak Incidence at 5 year old
      3. Milder case occur in children under age 2 years
    2. Adults
      1. Affects middle aged adults (32 to 50 years old)
  3. Gender
    1. Occurs more often in boys (2:1)
  4. Timing
    1. Occurs most frequently in spring and winter in children (no seasonality in adults)

III. Pathophysiology

  1. Upper Respiratory Infection precedes HSP in 60-75% cases
  2. Acute immune complex-mediated, small vessel Leukocytoclastic Vasculitis
  3. Idiopathic inflammatory IgA hypersensitivity
    1. Petechiae and Purpura
      1. IgA immune complexes deposit in small vessel walls of skin
    2. Gastrointestinal Hemorrhage
      1. IgA immune complexes deposit in small vessel walls of intestinal wall
    3. Crescentic Glomerulonephritis
      1. IgA immune complexes deposit in small vessel walls of renal mesangium

IV. Associated Conditions (preceding HSP)

V. Course

  1. Onset over days to weeks (following Upper Respiratory Infection in most cases)
  2. Duration: 4-6 weeks

VI. Symptoms: Classic Triad (beyond rash, triad is not uniformly present)

  1. Palpable Purpura rash on lower extremities (gravity dependent regions)
  2. Abdominal Pain or renal involvement (Nephritis)
  3. Arthritis or Arthralgias

VII. Signs: Rash (100% of cases)

  1. Timing
    1. Rash precedes other signs and symptoms of HSP
    2. First appears as erythematous Papules
    3. Crops of palpable Purpura and Petechiae follow
    4. Purpura may enlarge to Ecchymoses, transition from purple to rust colored, and fade over 10 days
  2. Distribution
    1. Gravity and pressure dependent
    2. Typically appears on extensor surfaces of lower extremities, belt line and buttocks
    3. Can involve face and trunk
  3. Characteristics: Petechiae or palpable Purpura (primary lesion type)
    1. Non-pruritic, non-blanching hemorrhagic lesions (palpable Purpura and Petechiae)
      1. Initially they may blanch on pressure; later they do not
      2. Lesions may become hemorrhagic or necrotic
    2. Transition from purple to rust-colored and then fade over a 10 day period
  4. Characteristics: Other associated lesions
    1. Urticarial wheels
    2. Erythematous Macules
    3. Erythematous Papules
    4. Target lesions
      1. May appear similar to Erythema Multiforme

VIII. Signs: Abdominal Pain (60-80% of cases, especially in children)

  1. Diffuse, Colicky Abdominal Pain (may mimic Acute Abdomen)
  2. Abdominal Pain onset typically follows rash
  3. Stools may show occult or gross blood
  4. Hematuria
  5. Vomiting or Hematemesis (rarely severe) in up to 30% of patients
  6. Intussusception occurs in 2-5% of HSP cases

IX. Signs: Joint Involvement (70% of cases, especially in children)

  1. Arthritis precedes rash in 25% of cases
  2. Transient Arthritis with no permanent deformity or damage
  3. Non-Migratory polyarthritis
    1. Ankles and knees most commonly affected
    2. Elbows, hands and feet may also be affected

X. Signs: Renal Disease (25-50% of cases)

  1. General
    1. Most serious complication of HSP
  2. Risk Factors
    1. Age over 10 years old and adults
    2. Persistent Purpura
    3. Gastrointestinal Bleeding
    4. Severe Abdominal Pain
    5. Relapsing episodes
    6. Male gender
  3. Presentation
    1. Develops within 3 months of rash (typically within first month and rarely beyond 6 months)
    2. Hematuria most common presenting sign (also accompanied by red cell casts and Proteinuria)
    3. Persistent Proteinuria increases risk of progressive Glomerulonephritis
    4. Risk of ESRD in 1% of patients over subsequent months

XI. Signs: Miscellaneous

  1. Most common associated findings in adults
    1. Hypertension
    2. Lower extremity edema

XII. Complications (more common in adults)

  1. Most common complications
    1. Gastrointestinal Bleeding
    2. Glomerulonephritis
  2. Cardiopulmonary conditions
    1. Myocardial Infarction
    2. Pulmonary Hemorrhage
    3. Pleural Effusion
  3. Gastrointestinal conditions
    1. Intussusception (mural hematoma is lead point) in 2-5% of cases
    2. Gastrointestinal Bleeding
    3. Bowel infarction
  4. Neurologic conditions
    1. Headaches
    2. Behavior Changes
    3. Seizures
    4. Mononeuropathies
  5. Renal disorders: Crescentic glomeruloneprhitis
    1. Renal Failure
    2. Hematuria
    3. Proteinuria
  6. Male genitourinary conditions
    1. Orchitis
    2. Testicular Torsion

XIV. Diagnosis: EULAR/PReS Criteria

  1. Background
    1. Replaces ACR 1990 criteria
    2. Lab tests are not required to make diagnosis (i.e. Purpura AND Arthralgias or Abdominal Pain)
  2. Major criteria (required)
    1. Purpura or Petechiae affecting the lower extremities
  3. Minor criteria (requires 1 of the following)
    1. Acute Arthritis or Arthralgia involving any joint
    2. Diffuse Acute Abdominal Pain
    3. Biopsy showing Leukocytoclastic Vasculitis or proliferative Glomerulonephritis with IgA deposition
    4. Renal involvement presenting as Proteinuria or Hematuria
  4. Efficacy
    1. Child: 100% Test Sensitivity and 87% Test Specificity
    2. Adult: 99% Test Sensitivity and 86% Test Specificity
  5. References
    1. Ozen (2010) Ann Rheum Dis 69(5): 798-806 [PubMed]

XV. Labs: Initial

  1. Complete Blood Count (CBC)
    1. Leukocytosis with Eosinophilia
    2. Platelets may be elevated
      1. Low Platelets suggest Thrombocytopenic Purpura
  2. Sedimentation rate (ESR) variably elevated
  3. Urinalysis: Nephritis evaluation (nephrology evaluation if positive)
    1. Most important lab in suspected HSP
    2. Hematuria or Proteinuria in up to 50% of patients
  4. Stool Guaiac
    1. Occult or gross blood may be present
  5. Renal Function tests (BUN, Creatinine)
    1. Obtain if positive urine for Hematuria or Proteinuria
    2. Elevation may suggest Hypersensitivity Vasculitis
  6. Coagulation Studies (PTT and INR)
    1. Normal in HSP
    2. Consider in differential diagnosis for Purpura

XVI. Labs: Other

  1. Consider ASO Titer
  2. Consider Blood Culture (in differential diagnosis for Purpura)
  3. Fecal Calprotectin
    1. Marker for gastrointestinal involvement

XVII. Labs: Histology

  1. Skin Biopsy (indicated in unclear diagnosis)
    1. Leukocytoclastic Vasculitis with IgA vascular deposits
  2. Renal Biopsy (indicated in progressive Glomerulonephritis)
    1. Glomerular crescents
    2. Indistinguishable from IgA Nephropathy

XVIII. Imaging

  1. Not routinely indicated
  2. Abdominal Ultrasound
    1. Indicated in suspected Intussusception in children
  3. Abdominal CT Abdomen
    1. Indicated for concurrent gastrointestinal symptoms suggestive of alternative diagnosis (esp. adults)
  4. Endoscopy
    1. May be indicated in gastrointestinal Hemorrhage
  5. Bronchoscopy
    1. Indicated in Pulmonary Hemorrhage

XIX. Management: General

  1. Supportive care (Primary strategy)
    1. Hydration
    2. Relative rest
    3. Elevate legs (may reduce Purpura)
  2. Rash
    1. No specific management
  3. Joint Pain
    1. Acetaminophen
    2. NSAIDs (with caution and avoid in renal involvement)
      1. Risk of renal disease
      2. Risk of Gastrointestinal Bleeding
  4. Nephritis (Hematuria or Proteinuria)
    1. Nephrology Consultation
    2. Renal biopsy
    3. Children with mild to moderate renal disease
      1. Systemic Corticosteroids are no longer recommended (see below)
    4. Adults and children with moderate to severe disease
      1. High dose Corticosteroids
      2. Immunosuppressants (e.g. Cyclosporine, Mycophenolate, Dapsone, Rituximab)
      3. High dose IV Ig
      4. Plasmapheresis

XX. Management: Systemic Corticosteroids

  1. Indications
    1. Children with severe extrarenal, refractory symptoms (e.g. Abdominal Pain, Joint Pain)
    2. Scrotal Swelling
    3. Children with renal involvement
      1. Previously recommended in mild-moderate cases
      2. As of 2013-2015, Corticosteroids (and cyclophosphamide) appear to have no benefit in non-severe disease
        1. Dudley (2013) Arch Dis Child 98(10): 756-63 [PubMed]
        2. Hahn (2015) Cochrane Database Syst Rev (8): CD005128 [PubMed]
  2. Dosing
    1. Prednisone 1-2 mg/kg orally daily for two weeks

XXI. Management: Hospitalization Indications

  1. Severe dehydration
  2. Intractable pain or Abdominal Pain requiring serial examination and observation
  3. Gastrointestinal Hemorrhage
  4. Inability to ambulate

XXII. Prognosis

  1. Excellent in general
    1. Resolves spontaneously in 94% of children
    2. Resolves spontaneously in 89% of adults
      1. However cases are more severe in adults with worse outcomes than with children
  2. Recurrence
    1. Relapse occurs in up to 30% of children, up to 50% of adults
    2. Relapse may be delayed as long as 10 years after prior episode
    3. Relapse is most common in adults with gastrointestinal symptoms
    4. Calvo-Rio (2016) Medicine 95(28):e4217 [PubMed]
  3. Renal Disease
    1. Up to 50% will have Hematuria or Proteinuria
    2. Longterm renal disease develops in 5% of cases overall
      1. Child: <1% develop End Stage Renal Disease
      2. Adult: Up to 11% develop End Stage Renal Disease
        1. Audemard-Verger (2017) Arthritis Rheumatol 69(9):1862-70 [PubMed]
  4. Predictors of serious nephropathy or ESRD
    1. Early onset of renal findings
      1. Abnormal Urinalysis on the day of HSP diagnosis (children)
      2. Renal involvement occurs within 6 weeks in 91% and 6 months in 97%
        1. Narchi (2005) Arch Dis Child 90(9):916-20 [PubMed]
      3. Low likelihood of chronic renal complications if no renal involvement by 6 months
      4. Nephritis at HSP diagnosis confers longterm Hypertension and urine abnormalities risks
      5. Nephrotic Syndrome at HSP diagnosis (lasting >3 months) confers longterm renal disease risk
    2. Bloody stools
    3. Rash persistence
    4. Renal Biopsy with glomerular crescents
      1. Progresses to ESRD in 100% of cases

XXIII. Monitoring

  1. Renal involvement screening
    1. Blood Pressure initially and at each subsequent visit following the HSP diagnosis
    2. Urinalysis in all patients at time of HSP diagnosis and periodic screening over subsequent 6 months
      1. Obtain monthly Urinalysis for 6 months if initial Urinalysis with Hematuria or Proteinuria
    3. If any Urinalysis suggests nephritis (Hematuria and Proteinuria)
      1. Serum Creatinine
      2. Blood Urea Nitrogen
  2. Cancer screening in adults with HSP over age 60 years
    1. Lung Cancer
    2. Renal Cancer
    3. Prostate Cancer

Images: Related links to external sites (from Bing)

Related Studies

Ontology: Henoch-Schoenlein Purpura (C0034152)

Definition (NCI) A systemic, usually self-limited immune complex vasculitis, characterized by immunoglobulin A deposition in the small vessels and kidneys. It is manifested with small hemorrhages in the skin, gastrointestinal symptoms, arthritis, and nephropathy.
Definition (MSH) A systemic non-thrombocytopenic purpura caused by HYPERSENSITIVITY VASCULITIS and deposition of IGA-containing IMMUNE COMPLEXES within the blood vessels throughout the body, including those in the kidney (KIDNEY GLOMERULUS). Clinical symptoms include URTICARIA; ERYTHEMA; ARTHRITIS; GASTROINTESTINAL HEMORRHAGE; and renal involvement. Most cases are seen in children after acute upper respiratory infections.
Concepts Disease or Syndrome (T047)
MSH D011695
ICD9 287.0
ICD10 D69.0
SnomedCT 191306005, 367437009, 31912009, 246074004, 267565009, 191305009, 154823001, 21148002, 191308006
English Henoch-Schoenlein purpura, Allergic Purpura, Anaphylactoid Purpura, Purpura, Schoenlein Henoch, Purpura, Schoenlein-Henoch, Schoenlein Henoch Purpura, Schoenlein-Henoch Purpura, PURPURA ALLERGIC, ALLERGIC VASCULAR PURPURA, ANAPHYLACTIC VASCULAR PURPURA, Allergic purpura, HENOCH-SCHONLEIN PURPURA, PURPURA ANAPHYLACTOID, PURPURA VASCULAR ALLERGIC, Purpura, Allergic, Purpura, Anaphylactoid, Allergic purpura NOS, HENOCH SCHONLEIN SYNDROME, Henoch-Schonlein purpura (disorder), Henoch-Schönlein purpura, Henoch-Schönlein purpura (disorder), Henoch Purpura, Purpura, Henoch, Henoch-Scholein purpura, Henoch-Sch@nlein purpura, allergic purpura (diagnosis), allergic vascular purpura (diagnosis), allergic purpura, Henoch Schoenlein Purpura, Henoch-Schoenlein Purpura, Purpura, Henoch-Schoenlein, allergic vascular purpura, Henoch Schonlein purpura, Henoch Schonlein purpura (diagnosis), vascular allergic purpura, Purpura allergic, Allergic vascular purpura, Purpura vascular allergic, Anaphylactic vascular purpura, Purpura anaphylactoid, Anaphylactoid vascular purpura, Schoenlein-Henoch purpura, Henoch Shonlein purpura, Henoch-Schonlein, Henoch-Schonlein purpura, Purpuras, Schonlein-Henoch, Henoch Schonlein Purpura, Schonlein-Henoch Purpuras, Purpuras, Henoch-Schonlein, Henoch Schonlein Purpuras, Purpura, Schonlein Henoch, Henoch-Schonlein Purpuras, Purpura, Henoch Schonlein, Schonlein Purpura, Henoch, Purpura, Schonlein-Henoch, Schonlein Purpuras, Henoch, Schonlein-Henoch Purpura, Henoch-Schonlein Purpura, Purpuras, Henoch Schonlein, Purpura, Henoch-Schonlein, Purpura Henoch(-Schönlein), Purpura, Schoenlein-Henoch [Disease/Finding], henoch shonlein purpura, henoch purpura, henoch schonlein purpura, henoch-schoenlein purpura (HSP), spring fever, henoch schoenlein purpura, anaphylactoid purpura, henoch-schonlein, henoch's purpura, henoch-schoenlein purpura, hsp, henoch scholein purpura, henoch schonlein, henoch-schonlein purpura, henoch-scholein purpura, Henoch-Sch?nlein purpura, Allergic purpura (disorder), Autoimmune purpura (disorder), Henoch-Schonlein all. purpura, Allergic purpura NOS (disorder), Purpura: [allergic] or [Henoch-Schonlein allergy], Purpura: [allergic] or [Henoch-Schonlein allergy] (disorder), Henoch-Sch?nlein purpura (disorder), Anaphylactoid purpura, Autoimmune purpura, Henoch's purpura, Acute vascular purpura, Henoch-Schoenlein vasculitis, Spring fever, HSP - Henoch-Schonlein purpura, Schönlein; purpura, Schönlein, allergic; purpura, purpura; Schönlein, purpura; allergic, purpura; anaphylactoid, anaphylactoid; purpura, Autoimmune purpura (disorder) [Ambiguous], Purpura, anaphylactoid, Purpura, autoimmune, Purpura;Henoch-Schonlein
French PURPURA ALLERGIQUE, PURPURA ANAPHYLACTOIDE, Purpura vasculaire anaphylactique, Purpura vasculaire allergique, Purpura vasculaire anaphylactoïde, Purpura de Schoenlein-Henoch, Maladie de Shölen-Henoch, Henoch-Schonlein, PURPURA DE HENOCH- SCHONLEIN, PURPURA VASCULAIRE ALLERGIQUE, PURPURA VASCULAIRE ANAPHYLACTIQUE, Péliose rhumatismale, Purpura allergique, Purpura anaphylactoïde, Maladie de Schönlein-Henoch, Purpura de Schönlein-Henoch, Syndrome de Schönlein-Henoch, Purpura de Henoch-Schönlein
Portuguese PURPURA ALERGICA, PURPURA ANAFILACTOIDE, Púrpura vascular anafilactóide, Púrpura vascular alérgica, Púrpura alérgica, Púrpura anafilactóide, Púrpura vascular anafiláctica, Schönlein-Henoch, Púrpura de Henoch, PURPURA ANAFILACTICA VASCULAR, PURPURA DE HENOCH-SCHOENLEIN, PURPURA VASCULAR ALERGICA, Púrpura Anafilactoide, Púrpura de Schönlein-Henoch, Púrpura Alérgica, Púrpura de Henoch-Schoenlein, Púrpura de Schoenlein-Henoch
Spanish PURPURA ALERGICA, PURPURA ANAFILACTOIDE, Púrpura alérgica, Púrpura vascular alérgica, Púrpura anafilactoide, Púrpura vascular anafilactoide, Henoch-Schönlein, Púrpura vascular anafiláctica, Purpura alérgica, Purpura vascular alérgica, Púrpura anafiláctoide, púrpura de Henoch-Schönlein (trastorno), púrpura de Henoch-Schönlein, púrpura de Schönlein-Henoch (trastorno), púrpura de Henoch-Shonlein (trastorno), vasculitis de Henoch-Shonlein, púrpura de Henoch-Shonlein, Púrpura de Henoch, PURPURA DE HENOCH-SCHONLEIN, PURPURA VASCULAR ALERGICA, PURPURA VASCULAR ANAFILACTICA, púrpura de Schönlein-Henoch, Purpura: [allergic] or [Henoch-Schonlein allergy], púrpura alérgica, SAI (trastorno), púrpura autoinmunitaria (trastorno), Allergic purpura, Henoch-Schonlein all. purpura, púrpura autoinmunitaria, púrpura de Schonlein-Henoch (trastorno), púrpura anafilactoide, SAI, púrpura de Scholein-Henoch, púrpura autoinmune, púrpura alérgica (trastorno), púrpura de Schonlein-Henoch, púrpura de Henoch - Schonlein, Púrpura: [alérgica] o [alergia de Henoch-Schonlein] (trastorno), púrpura alérgica, púrpura alérgica, SAI, Púrpura: [alérgica] o [alergia de Henoch-Schonlein], púrpura de Henoch - Schonlein (trastorno), púrpura anafilactoide, púrpura de Henoch - Schonlein (concepto no activo), púrpura de Henoch, púrpura vascular aguda, Púrpura de Schönlein-Henoch, Púrpura Alérgica, Púrpura Anafilactoide, Púrpura de Henoch-Schoenlein, Púrpura de Schoenlein-Henoch
Italian Porpora di Henoch-Schonlein, Porpora vascolare allergica, Henoch-Schonlein, Porpora vascolare anafilattica, Porpora di Henoch Schonlein, Porpora vascolare anafilattoide, Porpora allergica, Porpora anafilattoide, Porpora di Schoenlein-Henoch
Dutch allergische purpura, anafylactische vasculaire purpura, anafylactoïde vasculaire purpura, purpura van Henoch-Schönlein, anafylactoïde purpura, allergische vasculaire purpura, purpura allergisch vasculair, Schönlein; purpura, allergisch; purpura, anafylactoïd; purpura, purpura; Schönlein, purpura; allergisch, purpura; anafylactoïd, Henoch-Schönlein purpura, Allergische purpura, Henoch-Schoenlein, Henoch-Schoenlein, ziekte van, Schoenlein-Henoch, ziekte van, Anafylactoïde purpura, Henoch-Schönlein, Henoch-Schönlein, syndroom van, Henoch-Schönlein, ziekte van, Schönlein-Henoch, ziekte van
German anaphylaktische vaskulaere Purpura, anaphylaktoide vaskulaere Purpura, Henoch-Shonlein Purpura, Henoch-Schonlein, anaphylaktoide Purpura, allergische Purpura, Purpura vaskulaer allergisch, Purpura allergisch, allergische vaskulaere Purpura, Schoenlein-Henoch Purpura, Purpura anaphylaktoid, ALLERGISCHE VASKULAERE PURPURA, ANAPHYLAKTISCHE VASKULAERE PURPUR, HENOCH-SCHOENLEIN PURPURA, PURPURA ALLERGISCH, PURPURA ANAPHYLAKTISCH, PURPURA VASKULAER ALLERGISCH, Purpura anaphylactoides, Henoch-Schoenlein Purpura, Allergische Purpura, Anaphylaktoide Purpura, Henoch-Schoenlein-Purpura, Purpura Schoenlein-Henoch, Schoenlein-Henoch-Purpura
Japanese アナフィラキシー性血管性紫斑病, アレルギー性血管性紫斑病, ヘノッホ・シェーンライン, アナフィラキシー様血管性紫斑病, アレルギーセイケッカンセイシハンビョウ, ヘノッホシェーンライン, アレルギーセイシハンビョウ, アナフィラキシーセイケッカンセイシハンビョウ, アナフィラキシーヨウケッカンセイシハンビョウ, アナフィラキシーヨウシハンビョウ, シェーンライン・ヘノッホ紫斑病, シェーンラインヘノッホシハンビョウ, ヘノッホシェーンラインシハンビョウ, ヘノッホ・シェーンライン紫斑病, アナフィラキシー様紫斑病, アナフィラクトイド紫斑病, 血管炎-出血性, ヘーノホ-シェーンライン紫斑病, ヘーノホ紫斑病, リウマチ性紫斑病, アナフィラクトイド紫斑, 血小板非減少性紫斑, 紫斑病-シェーンライン-ヘノッホ, ヘノッホ紫斑病, 出血性血管炎, 紫斑病-アレルギー性, Henoch-Schonlein紫斑病, アナフィラキシー紫斑病, 紫斑病-血小板非減少性, シェーンラインヘノッホ紫斑病, Schoenlein-Henoch紫斑病, シェーンライン-ヘノッホ紫斑病, 血小板非減少性紫斑病, 紫斑病-ヘノッホ, Schonlein-Henoch紫斑病, 紫斑病-リウマチ様, リウマチ様紫斑病, アレルギー性紫斑病, 紫斑病-アナフィラキシー様, シェーンライン・ヘノッホ紫斑病, 紫斑性出血, Henoch-Schoenlein症候群, 紫斑病-Schoenlein-Henoch
Swedish Purpura, Schoenlein-Henochs
Finnish Henoch-Schönleinin purppura
Russian GENOKHA PURPURA, PURPURA NETROMBOTSITOPENICHESKAIA, SHENLEINA-GENOKHA PURPURA, VASKULIT GEMORRAGICHESKII, ALLERGICHESKAIA PURPURA, ANAFILAKTOIDNAIA PURPURA, REVMATOIDNAIA PURPURA, PURPURA SHENLEINA-GENOKHA, АЛЛЕРГИЧЕСКАЯ ПУРПУРА, АНАФИЛАКТОИДНАЯ ПУРПУРА, ВАСКУЛИТ ГЕМОРРАГИЧЕСКИЙ, ГЕНОХА ПУРПУРА, ПУРПУРА НЕТРОМБОЦИТОПЕНИЧЕСКАЯ, ПУРПУРА ШЕНЛЕЙНА-ГЕНОХА, РЕВМАТОИДНАЯ ПУРПУРА, ШЕНЛЕЙНА-ГЕНОХА ПУРПУРА
Czech Alergická purpura, Anafylaktická vaskulární purpura, Schoenlein-Henochova purpura, Henoch-Schoenlein, Anafylaktoidní purpura, Henoch-Schoenleinova purpura, Alergická vaskulární purpura, Anafylaktoidní vaskulární purpura, Henoch-Schönleinova purpura, anafylaktoidní purpura, Schönlein-Henochova purpura, alergická purpura, purpura Schoenleinova-Henochova, Henochova-Schönleinova purpura
Korean 알레르기성 자색반증
Croatian PURPURA, SCHOENLEIN-HENOCH
Polish Plamica reumatyczna, Plamica Schoenleina-Henocha, Plamica alergiczna, Choroba Schoenleina-Henocha, Zespół Schoenleina-Henocha
Hungarian Henoch-Schonlein purpura, Anaphylactikus vascularis purpura, Anaphylactoid vascularis purpura, Schoenlein-Henoch purpura, Henoch-Schonlein, Henoch-Shonlein purpura, Allergiás purpura, Allergiás vascularis purpura, Anaphylactoid purpura, Purpura allergiás, Purpura anaphylactoid, Purpura vascularis allergiás
Norwegian Allergisk purpura, Henoch-Schönleins purpura, Henoch-Schoenleins purpura