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Henoch-Schönlein Purpura (HSP), or IgA Vasculitis, in Children: A Guide for Parents

· Jun 18, 2025 ·

Henoch-Schönlein Purpura (HSP), now known as IgA vasculitis, is a type of inflammatory condition known as vasculitis, that affects the small blood vessels in the skin, joints, intestines, and kidneys. It is one of the most common types of vasculitis in children and typically occurs between the ages of 2 and 11 years old. While the exact cause of HSP is unknown, it is believed to be related to an abnormal immune system response, often triggered by a preceding infection.

What symptoms do you get?

Symptoms of HSP can vary but often include:

Purpura: Small, raised purple or red spots on the skin, typically on the legs and buttocks, which may be painful or itchy.
Joint pain and swelling, particularly in the knees and ankles.
Abdominal pain or cramping.
Nausea, vomiting, or bloody stools.
Kidney involvement, which may lead to blood or protein in the urine, decreased urine output, or high blood pressure.

It’s essential to seek medical advice if your child develops any of these symptoms, especially if they occur suddenly or worsen over time.

How is it diagnosed?

Diagnosing HSP in children usually involves a combination of a physical examination, medical history, and blood and urine tests. Blood tests are done to check for signs of inflammation and to assess kidney function, while urine is tested for blood and protein. Your child’s blood pressure will also be taken.

What is the treatment?

In most cases, HSP resolves on its own within a few weeks to months without specific treatment. However, symptomatic relief may be provided with over-the-counter pain relievers such as paracetamol to alleviate joint pain and discomfort. It’s essential to follow your healthcare provider’s advice closely and attend regular follow-up appointments to monitor your child’s progress as about half of children with HSP will have a further episode. Typically, your child will be followed up at regular intervals for one year.

Rarely, in more severe cases your child may require additional treatments such as medicines to reduce inflammation and protect organ function.

Most cases of HSP will be monitored and resolve without long-term complications. If you have any concerns about your child’s health or if their symptoms are severe or worsening, seek medical advice promptly.

Physiotherapy for upper limb fracture

· Oct 18, 2024 ·

What to expect after removing the cast or sling

To help your fracture heal, the decision may be made to immobilise your arm by placing it into a cast or sling for some time. This is typically around 4-6 weeks. This will be decided by your orthopaedic doctor.

After your cast is removed, you will probably have dry flaky skin, altered sensation, joint stiffness, muscle weakness and some swelling.

This leaflet will provide advice and exercises to help with these effects.

Skin Care

After your cast or sling is removed it is helpful to massage non-perfumed moisturiser over your shoulder and arm.

This will help hydrate the dry skin while also providing a positive touch to an area that has not been touched or moved for a period of time.

This will help with dry skin and sensory concerns.

Exercises

The following exercises will help reduce swelling and stiffness and increase your joint movement. Carry out these exercises regularly and gradually work through them.

The exercises get harder as you work through the leaflet so it may be a few weeks before you can manage them all.

Exercises may feel difficult at first but should not be painful. If an exercise is painful, you should stop and try again later.

Arm circles

Start with your hands by your side with your palms facing forward.
Bring your arms all the way up and over your head.
Return to the starting position.

Prayer stretch

Place your palms together just above your head and gently press them together.
Keeping your palms in contact slowly bring them down in front of your body and hold at the bottom for 20 seconds.
Repeat 5 times.

Quadruped Arm Raise

Begin on your hands and knees.
Raise one arm out in front of you. Try to keep your arm as straight as it will go.
Repeat with your other arm.
Repeat 10 times.

Child’s pose

Sit back on your heels.
Slide your hands forward to feel a stretch in your upper body and shoulders.
Take a deep breath and walk your fingers forward to increase the stretch.
Hold for 20 seconds.
Repeat 3 times.

Knee Push-Up

Start on your hands and knees.
Keeping your back straight, slowly lower your nose to the floor.
Straighten your arms and return to the starting position.
Repeat 10 times.

Activity ideas to encourage the use of your arms

Popping bubbles
Arts and crafts
Swimming
Bat and ball games
Animal walks
Wall push-ups
Skipping rope
Push/pull toys (prams, trolleys)
Building block towers on a table.

When to seek further help?

If your child reports the following complaints after 3 – 4 weeks of following the advice in this leaflet please call the physiotherapy team to discuss further assessment:

Ongoing pain which stops your child from taking part in normal activities
Difficulty returning to normal function
Ongoing stiffness.

Broad arm sling

· Oct 17, 2024 ·

Why your child needs a broad arm sling

A broad arm sling is used to help support and protect injured shoulders, arms, wrists and hands after an injury. It can be worn over or under clothes.

How to apply the sling

illustration of instructions in a paragraph below

Step 1

Place the injured arm across the body with the sling underneath. Position the point of the sling to the elbow.

Step 2

Fold the bottom corner up over the opposite shoulder and tie the ends of the sling comfortably behind the neck.

Step 3

Gather the loose material at the elbow and secure it with tape.

How to care for your child’s arm and sling

Keep the sling clean and dry.
Remove the sling at night as it is not safe to sleep in.
The arm can be placed on a pillow overnight to keep it raised.
When dressing, put clothes on the injured arm first, and take them out of clothes last.

Pain relief in children

· Sep 26, 2024 ·

Paracetamol for children (often called Calpol)

Paracetamol is a common painkiller for children with mild to moderate pain (for example headaches and stomach aches). It can also be used to treat a temperature over 38ºC. Calpol is one brand of paracetamol, but others are available.

Your child should start to feel better about 30 minutes after taking paracetamol. Do not give paracetamol to babies younger than 3 months old unless you have been advised to by a healthcare professional.

How often should I give paracetamol?

You should wait at least 4 to 6 hours between doses of paracetamol. Give no more than 4 doses of paracetamol in 24 hours.
What if my child has too much paracetamol?

If you give your child 1 extra dose of paracetamol by mistake, wait at least 24 hours before giving them any more. If you are in any doubt, you should contact 111 for advice.

What if my child has too much paracetamol?

If you give your child 1 extra dose of paracetamol by mistake, wait at least 24 hours before giving them any more.

If you are in any doubt, you should contact 111 for advice.

Ibuprofen for children (can be called Nurofen, Calprofen, Brufen)

Ibuprofen is a common painkiller for children with mild to moderate pain. It can also be used to treat a temperature over 38ºC. Nurofen, Calprofen and Brufen are brand names for Ibuprofen, but others are available.

It is best to give ibuprofen with food, so it doesn’t upset your child’s tummy. Your child should start to feel better about 30 minutes after taking ibuprofen.

Do not give ibuprofen to your child if they have asthma or chicken pox unless advised to by a healthcare professional.

How often should I give ibuprofen?

You should wait at least six hours between doses of ibuprofen. Give no more than 3 doses of ibuprofen in 24 hours.

What if my child has too much ibuprofen?

If you give your child 1 extra dose of ibuprofen by mistake, wait at least 12 hours before giving them any more.

If in doubt call 111 for advice.

How much paracetamol or ibuprofen should I give?

You should follow the instructions on the bottle carefully to make sure you give the correct amount of medicine.

There are different strengths of paracetamol and ibuprofen syrup available – make sure you are using the correct strength for your child’s age.

It can be useful to write down the time that you give each dose.

Can paracetamol and ibuprofen be given together?

Paracetamol and ibuprofen can be given together when using to treat pain and work better for pain used this way. You can also stagger them so that every few hours if needed, the child can have some medication.

For example, you can give paracetamol at 8 am, ibuprofen at 11 am and paracetamol again at 2 pm (i.e. 6 hours after the first dose of paracetamol). Do not give more than 4 doses of paracetamol in 24 hours. Do not give more than 3 doses of ibuprofen in 24 hours.

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