Henoch-Schönlein Purpura - Are You Freakin' Kidding Me? (Also known as my 200th post)

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This is a post about HSP.  If you are reading this sometime in the future, and you have stumbled upon this blog, please know that I am not a health care professional, but I am a mom documenting our family's history.  So please read on, but know that this is our story, and should not be used to diagnose or treat HSP.  If you think you or your child has HSP, trust your gut and go to the doctor.

It all began a few days before Christmas. 

Miss A had a high fever one night (Dec. 23), and we decided that she should not come to the Nativity practice. 

On Christmas Eve (Dec. 24), I called and arranged to have Miss A seen by the doctor at the clinic in town. 

 

The doctor checked her over, agreed that she was sick, but thought it was likely viral.  She said her throat looked red and that her tonsils were big, so she did a throat swab to be sure it wasn't a bacterial infection (and, because I am writing this in the future, I can tell you that it was not a bacterial infection). 

Then, on Christmas Eve night, her high fever returned (40 degrees Celsius), so she skipped being a sheep in the Nativity and slept at home with Daddy. 

Her fever broke over night, at precisely 1:30 am.

I remember this vividly because Miss A bounced into my bed eager for the day to begin, and asking me if we could get a Super Why DVD about sharks (I told her "yes, once I find it for sale). 

She talked my ear off until 7 am, and her sister only woke up at 8 am on Christmas morning.

We'll skip ahead to Dec. 28th, our anniversary.

That night, as I was giving the girls a bath, I noticed that Miss A had a strange rash on her legs. 

At first glance, I thought she had bumped into something (as one of the spots was sort of open, like a scrape), but upon closer inspection, I could see that she had spots all over her legs, below the knees. 

Immediately, I pulled her out of the tub, dried her off and checked her over.

She was totally confused because they were not painful and they were not itchy.

I was totally confused because there were no spots on her trunk, where all of my Kindergarten teacher years of experience tell me that most childhood rashes begin.

So, I did what anyone would do, I called a friend.  Actually, I called a cousin. 

Monique and Eric are both nurses and between us we all decided that it might be related to the fever, and with no other symptoms we'd see if she sleeps, and then get it checked in the morning.

She did sleep, but she did not want to walk to bed.

Why?

Well, it turns out that her ankles were swollen!

And, some of the rash morphed into these bruise-like blemishes.

On the opposite leg, you can see one of the spots that is more like a sore.

And, again, only on the leg below the knee and the feet.

Eli and I hummed and hawed.  I called the emergency room, and they agreed with my initial idea that if she is sleeping, to let a sleeping babe sleep.

First thing in the morning (Dec. 29) she was happy and playing, but I got her back to the health clinic.

Her ankles were still swollen, but the swelling had definitely gone down.

The doctor on call was concerned, and ran a few tests, consulted his medical computer, and settled on a diagnosis:

Henoch-Schönlein Purpura (pronounced: heh-nok shoon-line purr-puh-ruh)

Commonly, it is referred to as HSP.

If you Google HSP, you'll get a whole bunch of scary stories, so I don't really recommend it. 

However, I am giving you a link to Kids Health, so that some family members can educate themselves on it a bit, if they wish. 

Eli also liked the Mayo Clinic link.

This is an excellent link to another more technical description of HSP:  National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) in the US.

The doctor explained that the rash and the joint pain (and swelling) could last for up to 4 to 6 weeks, then it will go away on its own

Treatment of the symptoms is ibuprofen (for the inflammation) and acetaminophen (for the pain).

But, the main concern with HSP is kidney damage or intestinal complications because, essentially, this rash can happen on the inside, which is why he did a urine test, and checked her blood pressure (all good).

This was on Saturday morning (Dec. 29), and he arranged to make an appointment for Monday morning to monitor the progress, and told me to go to the Emergency Room if anything weird were to happen.

So, we went home and had a regular goofy Saturday. 

And, Eli managed to get his truck into the garage, which was quite an accomplishment.

We were just talking about how the rash was fading and how Miss A was doing so well on Sunday night (Dec. 30) when Miss G threw up.

I can't make this up.

Then, Miss A said, "OW!  My leg hurts!"

We divided and conquered.

Daddy stayed home with Poor Pukey Pookie, and Miss A and I took off for the ER. 

She could not walk on her own.

Miss A's left knee swelled to the size of a baseball, and her right knee was swelling, too. 

Not only did her knees swell, but both feet swelled to the point we could not get snow boots on. 

All of these pictures do not capture the rash and joint swelling adequately, but they should give you some idea.

She cried because she thought that her feet would freeze in Yellowknife if she didn't have boots on, but I assured her that her wool socks would keep her warm, and that Mommy would carry her.

Her right foot was giant! 

It was swollen on the top, wrapped around the outer edge and was swollen on the bottom.

A hot dog bun swelling sensation, if you will. 

The left foot was swollen, but not so bad.

Miss A got lots of uninterrupted time with the girls' new Innotab, which was awesome for our 5 hour visit to the ER.

Patchy-Patch came, too! 

We had snacks, and chatted with the triage nurse who got us this room as soon as we arrived (I think, as to shelter Miss A from some of the more unsavoury visitors to the ER on a holiday night).

On that theme, the triage nurse asked me how many drinks Miss A has each day.

I asked, "Water or milk?"

She laughed, nodded to the waiting room and said, "Sorry.  It's been a long night."

The nurse was very interested in HSP, and thought Miss A was a delight.

At one point, she asked Miss A what school she goes to.

Miss A said, and I quote:  "Um. Uh.  I go to the JE-sus School." 

I laughed for about half-an-hour about that.

The rash had spread up the legs, and to the bottom of the tushie.  The picture is of the back of her legs.

There were even a few spots on the tummy and one on an arm.

After a wait, the ER doctor agreed with the HSP diagnoses, ran a urine test, checked her blood pressure, and did a complete blood test. 

Everything came back fine, so we went home to sleep. 

This morning (Dec. 31), we were back to the health clinic to see the original doctor from Saturday morning who diagnosed the HSP. 

Miss A is a master at waiting, now. 

The doctor ran the same tests, consulted with a paediatrician to confirm HSP, and said that all the medical tests are good for now.

We'll continue to have her kidneys checked for the duration of the symptoms (and maybe longer).

The doctor said to expect more swelling and the rash to stay, but to come back if anything new happens, especially tummy trouble, so we're on standby.

The rash stabilized, and has not yet appeared in any new places since last night.

The swelling went down, though as I type this on Monday night, her feet and knees are still a tad swollen, and they are quite bruised looking, especially where the swelling was.

That's old nail polish on her toes.

The doctor says there is no cause for alarm, just cause to monitor, and so we will.

I don't think I could have written this post any sooner because it all needed to happen so I knew the story and sequence, but we have come to a logical spot where a chapter would end, so the post fits now. 

* No complaints if I did not personally call you to tell you about this. *

I'll keep you all up to date as we get more information, but please pray with us that the rash and swelling are the only symptoms Miss A gets. 

Everything up to now has been very positive, and we have no reason to expect any complications.

Positive thinking is what I do best!  Eli worries enough for both of us.