Henoch-Schönlein Purpura (HSP): what can we learn from biomedical and clinical anatomy practice on this multidisciplinary disease?

Background: Henoch-Schönlein Purpura (HSP) is the most common vasculitis in children, characterized by triad of symptoms; 1) palpable purpura without thrombocytopenia, 2) abdominal pain, and 3) arthritis. Renal involvement also often occurs in children with HSP. Henoch-Schönlein Purpura (HSP) is the most common vasculitis in children, occurring in 8 to 20.4 per 100,000 children per year. Epidemiology: HSP usually occurs in children aged between 2-10 years, with 50% of all cases occurred in children aged <5 years, mostly in children aged 4-6 years and occurs more frequently in male. Although it is generally a self-limiting condition, HSP can cause renal manifestations with various incidences. The guidelines and treatment for managing care in HSP patients ranges between centers. Aims: 1) To provide practical understanding of Henoch-Schonlein Purpura (HSP), 2) Highlight the importance of multidisciplinary laboratory practice for patients with HSP, and 3) Highlight what laboratory practices could be enhanced to support the development of HSP guidelines. Practice: HSP is a multi-specialty disease wherein a patient’s care plan will have laboratory involvement from a variety of disciplines. Laboratory investigations suggest that HSP is not a self-limited disease and patients eventually develop CKD. Research Stance: In a retrospective study of 141 patients with HSP, Zhao et al. 2015 (9) demonstrated that abdominal pain was not related to HSP Nephritis (HSPN). However, 45% of the patients were complicated with obesity and 29.8% of them had a long disease course. Multidisciplinary laboratory perspectives are paramount in disease follow-up and to help inform clinical decision-making. Discussion: Future biomedical/ laboratory practices can help tighter clinical decision-making in the care of young people with HSP. More case and longitudinal studies would be helpful to understand whether patients would benefit different care plan options. Conclusion: Evidence informs that male gender, age greater than 10 years, have symptoms of severe gastrointestinal involvement, arthritis/arthralgia. So, what can we learn from this multidisciplinary disease? Certainly, well-designed and conventionally reported studies in histology, microbiology and hematology laboratory collaborations are important to identify HSP disease development and progression.