Henoch-Schonlein Purpura—A Case Report and Review of the Literature

Table 3

Treatment of HSP, indications for different medications: [1, 10–12].

Medications	Indication	Comments
Acetaminophen, NSAIDs	Mild rash, arthritis
Oral steroids (1-2 mg/Kg)	Severe rash, cutaneous edema, severe colicky abdominal pain, scrotal and testicular involvement	These cannot prevent development of systemic involvement but can be helpful for symptomatic treatment. These decrease the duration of symptoms when compared to placebo group
IV steroids (1-2 mg/Kg)	Same as oral steroids, should be given if patient is not able to tolerate oral medications	Same as oral steroids
High-dose IV pulse steroids	Nephrotic range proteinuria	Decreases ESRD progression (in some case series and reports)
High-dose IV pulse steroids plus immunosuppression	Rapidly progressive glomerulonephritis (RPGN), hemorrhagic involvement of lungs, brain	Grade D recommendation
Plasmapheresis and/or IV immunoglobulin therapy	Refractory HSP to combination therapy (steroids and immunosuppression), massive hemorrhage in gastrointestinal or other organs	Grade D recommendation, but evidence is growing with multiple case series and reports. This is used as the last resort to treat refractory HSP.