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Tests and diagnosis
By Mayo Clinic staffNo single laboratory test can confirm Henoch-Schonlein purpura, but certain tests can help rule out other diseases and make a diagnosis of Henoch-Schonlein seem likely.
In addition to conducting a physical exam and taking a medical history, your doctor may request several tests, including:
- Blood tests. An elevated level of a special type of protein called IgA may suggest Henoch-Schonlein purpura, but it isn't conclusive. Another indication may be an elevated erythrocyte sedimentation rate — commonly referred to as sed rate. By measuring how quickly red blood cells fall to the bottom of a tube of blood in an hour, this test may indicate the level of inflammation in the body. Blood test results also may rule out conditions other than Henoch-Schonlein purpura, such as an inflamed pancreas (acute pancreatitis) or another type of vasculitis. If there is any doubt about the diagnosis, your doctor may check the number of platelets — the cells that help blood clot — in the blood.
- Urine tests. These evaluate kidney function to determine whether the disease is affecting the kidneys. It can take several months after the appearance of the rash for the kidneys to be affected, so your doctor may want to repeat the urine tests monthly for up to six months. Blood in the urine, as well as elevated levels of certain proteins, can help your doctor determine the extent to which the kidneys are affected by the disease.
- Skin biopsy. If other tests are inconclusive, your doctor may take a small sample of skin that's sent to a lab and examined under a microscope.
- Imaging studies. Your doctor may request a computerized tomography (CT) scan to rule out other causes of abdominal pain, such as appendicitis, a tear in the bowel (perforation) or bowel obstruction.
- Kraft DM, et al. Henoch-Schonlein purpura: A review. American Academy of Family Physicians. http://www.aafp.org/afp/980800ap/kraft.html. Accessed Aug. 10, 2008.
- Dedeoglu F, et al. Management of Henoch-Schonlein purpura. http://www.uptodate.com/home/index.html. Accessed Aug. 10, 2008.
- Dedeoglu F, et al. Clinical manifestations and diagnosis of Henoch-Schonlein purpura. http://www.uptodate.com/home/index.html. Aug. 17, 2008.
- Gibson KL, et al. Corticosteroid therapy for Henoch-Schonlein purpura. Pediatrics. 2008;121(4):870-871.
- Henoch-Schonlein purpura. Vasculitis Foundation. http://www.vasculitisfoundation.org/HenochSchonleinpurpura. Accessed Aug. 10, 2008.
- Weiss PF, et al. Effects of corticosteroid on Henoch-Schonlein purpura: A systematic review. Pediatrics. 2007;120(5):1079-1087.
- Henoch-Schonlein Purpura. National Kidney and Urologic Diseases Clearinghouse. http://kidney.niddk.nih.gov/kudiseases/pubs/HSP. Accessed Aug. 10, 2008.
