Case records of the Massachusetts General Hospital. Weekly clinicopathological exercises. Case 5-1983. A 72-year-old man with palpable purpura, proteinuria, and microscopic hematuria

Henoch-Schönlein purpura

The clinical features of 25 children with Henoch-Schönlein purpura are presented, with particular emphasis on the cutaneous features. Although every patient exhibited purpura on the buttocks and lower extremities, it was preceded by a maculopapular or urticarial rash in nine. Moreover, cutaneous features were preceded by arthralgia or abdominal pain by up to two weeks in 40% of the patients. Other dominant clinical features included arthralgia in 84%, abdominal pain in 76%, nephritis in 44%, and gastrointestinal bleeding in 40%. Laboratory studies reflected the acute, systemic nature of the illness, but generally were of limited diagnostic value.