Henoch-Schönlein Purpura - Diagnosis

Authored by Dr Colin Tidy, 15 Jul 2017

Patient is a certified member of
The Information Standard

Reviewed by:
Dr Adrian Bonsall, 15 Jul 2017

Henoch-Schönlein purpura (HSP) is usually suspected because of the typical symptoms. However, a number of investigations may be suggested to help doctors confirm the diagnosis and to see which body parts may be affected by the inflammation. Investigations may include the following:

  • Blood tests - for example:
    • To look at how the kidneys are working.
    • To look for any signs of recent Group A streptococcal infection.
    • To confirm that platelet levels are not low. (Platelets are a type of blood cell. In some conditions, a rash similar to that in HSP develops because platelet levels have become too low for some reason.)
    • To look at immunoglobulin A levels which are usually high in HSP.
  • Skin biopsy - if the diagnosis is uncertain, a biopsy of the skin may be suggested. A very small sample of skin affected by the rash is taken and examined underneath the microscope. There is a typical appearance under the microscope in HSP.
  • Urine dipstick test - a special testing strip can be dipped into a sample of urine to look for signs of any kidney involvement. For example, signs of traces of protein or blood in the urine which may not be seen by the naked eye.
  • A blood pressure check - blood pressure can be raised if HSP involves the kidneys.
  • Kidney biopsy - if signs of more severe kidney problems develop (for example, blood tests to look at how the kidneys are working show that they are struggling), a procedure in which a sample of the kidneys is taken (a biopsy) may be suggested. This can give more information about the kidney inflammation and how severe it may be. See separate leaflet called Kidney Biopsy (Renal Biopsy) for more details.
  • Stool test - to look for any signs of blood in the stools (faeces). If there is bleeding within the gut (gastrointestinal bleeding), this can lead to blood in the stools, which sometimes cannot be seen by the naked eye. A special test on the stools can pick up microscopic traces of blood.
  • Other tests - if other complications develop, certain other tests may be suggested. For example, if pain in the scrotum develops, an ultrasound scan of the scrotum may be suggested.

Further reading and references

Hi everyone,Like most of you, my diagnosis of HSP was complicated and drawn out but I have had symptoms for over two years now - rash, joint pain, stomach pain with loose or bloody stools, etc. I...

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