Criteria
EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura[30]
Ankara 2008 classification definition:
Purpura or petechiae (mandatory) with lower limb predominance and at least one of the four following criteria:
Abdominal pain
Histopathology
Arthritis or arthralgia
Renal involvement.
European consensus-based recommendations for diagnosis and treatment of immunoglobulin A vasculitis - the SHARE initiative[29]
Recommends that EULAR/PRINTO/PRES clinical criteria should be used to classify IgAV.
A skin biopsy including specific immunofluorescence staining for IgA should be performed in case of atypical rash and/or to exclude alternative diagnoses; skin biopsy is not needed in a patient with the typical purpuric skin rash on lower limbs and buttocks. Absence of IgA immunofluorescence staining on biopsy does not exclude the diagnosis of IgAV.
Renal involvement should be investigated using estimated glomerular filtration rate (eGFR) and urinalysis. A paediatric nephrologist should be consulted if a patient with IgAV has moderate proteinuria and/or impaired GFR. A renal biopsy should be performed if a patient with IgAV has severe proteinuria.
In severe abdominal pain, ultrasound should be performed by an ultrasonographer with paediatric expertise to exclude intestinal intussusception.
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