The criteria for Henoch-Schonlein purpura in pediatric patients was revised in 2008 at a conference in Ankara. The EULAR, PRINTO and PRES were involved in development.
Criteria for Henoch-Schonlein purpura - both of the following:
(1) purpura or petechiae (mandatory) with lower limb predominance and not related to thrombocytopenia; purpura commonly palpable and in crops
(2) one or more of the following:
(2a) abdominal pain (diffuse, colicky, with acute onset; may include intussusception or gastrointestinal bleeding)
(2b) histopathology (leukocytoclastic vasculitis and/or proliferative glomerulonephritis with predominant IgA deposits on immunofluorescence)
(2c) arthritis (acute onset of joint swelling or pain with limitation of motion) or arthralgia (acute onset of joint pain without joint swelling or limitation on motion)
(2d) renal involvement (proteinuria > 0.3 g per 24 hours; > 30 mmol/mg urine albumin to creatinine ratio; hematuria with dipstick >= 2+ or > 5 RBCs per high power field; red blood cell casts)
where:
• The units for the urine albumin to creatinine ratio may be mg/mmol.
If the purpura or petechiae show an atypical distribution, then histopathology (IgA deposits) must be present.
Performance:
• The sensitivity is 100% and specificity 87%.
• The area under the ROC curve is 94%.
