Gastroenterology Research and Practice / 2010 / Article / Tab 3

Case Report

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

Table 3

Treatment of HSP, indications for different medications: [1, 1012].

MedicationsIndicationComments

Acetaminophen, NSAIDsMild rash, arthritis
Oral steroids (1-2 mg/Kg)Severe rash, cutaneous edema, severe colicky abdominal pain, scrotal and testicular involvementThese 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 medicationsSame as oral steroids
High-dose IV pulse steroidsNephrotic range proteinuriaDecreases ESRD progression (in some case series and reports)
High-dose IV pulse steroids plus immunosuppressionRapidly progressive glomerulonephritis (RPGN), hemorrhagic involvement of lungs, brainGrade D recommendation
Plasmapheresis and/or IV immunoglobulin therapyRefractory HSP to combination therapy (steroids and immunosuppression), massive hemorrhage in gastrointestinal or other organsGrade D recommendation, but evidence is growing with multiple case series and reports. This is used as the last resort to treat refractory HSP.

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