Which procedures may be warranted in the diagnosis of Henoch-Schönlein purpura (IgA vasculitis)?

Updated: Jan 08, 2021
  • Author: Rajendra Bhimma, MBChB, MD, PhD, DCH (SA), FCP(Paeds)(SA), MMed(Natal); Chief Editor: Craig B Langman, MD  more...
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Answer

Other studies that may be warranted are as follows:

  • Endoscopy - Purpuric lesions may be seen in the descending duodenum, stomach, and colon. The terminal ileum and jejunum may also be involved, with submucosal edema, ulceration, and spasm.
  • Kidney biopsy (particularly when nephrotic syndrome persists and when kidney function deteriorates). The severity of kidney involvement correlates with findings on kidney biopsy,  Light microscopic findings can range from mild mesangial proliferation to crescentic glomerulonephritis. Diffusion mesangial IgA deposits with co-deposition of C3 complement (seen in about 75% of cases) is the hallmark of the disease. The absence of C1q and C4 classical complement pathway components distinguishes glomerulonephritis from other forms of immune-mediated glomerulonephritis (eg,  lupus nephritis).

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