Brief Answer:
Recurrence is not unsual in HSP

Detailed Answer:
Hi...Usually HSP is an acute self-limited illness and usually resolves without treatment, but may rarely lead to complications. Initial attacks of HSP can last for several months. One in every four patients will have one or more recurrences....so it is 4% in general population. There is no way by which we can find out will get a recurrence and who do not.But usually, kids younger than 3 years have a shorter, milder course and fewer recurrences. I do not know about the age of your kid but this is what the scientific community says about recurrence of HSP.
Uncomplicated recurring HSP is always self limiting...do not worry.
Sometimes in HSP the kidney can get involved and usually the long-term prognosis of HSP is directly dependent on the severity of renal involvement.

regards - Dr. Sumanth

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Brief Answer:
HSP follow up - precautions

Detailed Answer:
Hi...I understand your concerns and completely sympathize with the recurrences your kid is having at such an young age. Coming to your queries directly -
1. Pain in the backside of left knee - is a very common symptom and is not at all peculiar as the joints and the tissues in and around the joints are commonly involved and will cause pain in HSP.
2. Reduced appetite with toxic face looks - This too is not a peculiar symptom as the kid might have some pain and usually kids of this age usually have recued appetite and toxic appearance whenever they have the acute exacerbation of symptoms.
Do not think that I am trying to take the side of the disease and ruling out everything as routine...I am telling this you because unless you know that these symptoms are a regular part of any kid who has these recurrences, your mind will not be at peace.

3. Coming to your 3rd query, regarding cough during the episode - any HSP recurrence can be due an inter-current viral illness which can as well cause cough which can be very dry and disturbing. Any cough suppressants will do.

4. Treatment in a long term perspective - The only option I would prefer at such situations is a low dose long term steroid but this will be my option only if the kid is know to have a renal involvement. When there is no evidence of renal involvement, till now, no treatment has been proved to be effective in preventing either complications or recurrences. Sorry I had to be XXXXXXX with you.

5. Precaution - The only precaution I would advise is to have a regular 3 -6 months once evaluation of renal function tests and urine routine examination. This will help pick up renal involvement if any.

I wish your kid a speedy recovery. If you need any future medical consultation and suggestions, I will be glad to help. You can approach me at the following link. Please find the link below.
www.healthcaremagic.com/doctors/dr-sumanth-amperayani/67696

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