Vasculitis in childhood occurs when there is inflammation in the walls of blood vessels. There are several different varieties of vasculitis depending on the size of the blood vessels involved. The two most common types of vasculitis in children are:
- Henoch-Schönlein purpura (HSP). This type of vasculitis usually occurs soon after a child has recovered from an upper respiratory tract infection. The condition typically affects children between the ages of 5 and 15. The symptoms of HSP usually get better over time without treatment.
- Kawasaki disease. This type of vasculitis causes inflammation in the medium-sized arteries throughout the body, including in the coronary arteries that carry blood to the heart. Signs and symptoms of this condition also usually disappear on their own, though full recovery can take as long as eight weeks.
The symptoms of HSP—which are indicative of HSP when they appear together—are:
- Purple spots (purpura) on the skin
- Arthritis or joint pain
- Abdominal pain
The symptoms of Kawasaki disease include:
- Fever higher than 102.2 degrees Fahrenheit, lasting longer than five days
- Extremely red eyes
- Rash on the trunk of the body
- Red, dry and cracked lips
- Extremely red, swollen tongue
- Swollen, red skin on the palms of the hands and the soles of the feet
- Peeling of the skin in large sheets, often on the hands and feet
- Joint pain
- Diarrhea
- Vomiting
- Abdominal pain
Diagnosis of Vasculitis in Childhood
To diagnosis vasculitis, your child’s doctor may run one or more of the following tests:
- Blood test. The blood can be analyzed for white blood cell count—likely to be elevated—as well as for the presence of certain antibodies, anemia or markers of inflammation.
- Ultrasound. An imaging test like an ultrasound may be used to rule out other possible causes of abdominal pain and to check for possible complications like a blocked bowel.
- Biopsy. Your child’s doctor may biopsy (obtain a small tissue sample) the affected area for careful analysis in the laboratory.
If your child has been diagnosed with vasculitis, seek the guidance of a pediatric rheumatologist who is experienced in treating the condition in children.
Treatments
Treatments
The symptoms of HSP often improve on their own within about a month, without long-term effects. Your child’s doctor will likely recommend rest, plenty of fluids and over-the-counter pain medicine. In rare cases when a section of the bowel has folded in on itself or ruptured, your child’s doctor will need to surgically repair this damage.
If your child has Kawasaki disease, the goals of early treatment are to reduce fever and inflammation and to prevent heart damage. This treatment will be administered in the hospital, and your child’s doctor may prescribe:
- Gamma globulin. This is an immune protein that may be delivered directly to your child’s bloodstream to help reduce the risk of coronary artery problems due to Kawasaki disease.
- Aspirin. Though as a rule aspirin should not be given to children, treatment of Kawasaki’s is an exception. High doses of aspirin can help reduce inflammation, decrease pain and joint inflammation and lower fever.
After your child’s fever goes down, your child’s doctor may recommend that he or she take low-dose aspirin for the next six weeks to reduce the risk of blood clotting, which can be associated with Kawasaki disease. When quickly and properly treated, Kawasaki disease usually runs its course over about eight weeks. Your child’s rheumatologist will likely recommend regular follow-up visits to monitor your child’s heart function and make sure the Kawasaki disease has not caused any long-term complications.
Key Points to Remember
Key Points to Remember
- There are several types of vasculitis that can occur in childhood; the two most common types are HSP and Kawasaki disease.
- Kawasaki disease affects the medium-sized blood vessels of the body—including the coronary arteries. It is important that your child receives treatment for this condition to avoid long-term damage to the heart.
- Children with HSP usually recover within a month and do not require special treatment beyond rest, adequate fluid intake and over-the-counter pain relievers.
Support Services & Resources
Support Services & Resources
Visit the trusted websites below to learn more about vasculitis in childhood:
Riley at IU Health offers a broad range of supportive services to make life better for families who choose us for their children's care.
The American College of Rheumatology provides education and support for patients and families living with vasculitis.
This U.S. National Library of Medicine website shares in-depth information about HSP, including its causes and symptoms.
This site discusses Kawasaki disease in detail.
Locations
Locations
Locations
In addition to our primary hospital location at the Academic Health Center in Indianapolis, IN, we have convenient locations to better serve our communities throughout the state.
Riley Pediatric Rheumatology
575 Riley Hospital Dr
Indianapolis, IN 46202
Riley Pediatric Rheumatology
11725 N Illinois St
Carmel, IN 46032