Medical Conditions

Henoch-Schonlein Purpura (IgA Vasculitis) in Children

Medically reviewed by Dr. Michael Okonkwo, MD, FAAP · Board-Certified Neonatologist

Content reviewed against published AAP, NIH, CDC guidelines

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If your baby has been diagnosed with or you suspect henoch-schonlein purpura (iga vasculitis) in children, here is what the evidence says.

The short answer

Henoch-Schonlein purpura (HSP), also called IgA vasculitis, is an inflammation of small blood vessels that causes a distinctive purple or reddish rash (purpura), joint pain, and sometimes abdominal pain or kidney involvement. It most commonly affects children between 2 and 6 years but can occur in toddlers. HSP often follows an upper respiratory infection. While it looks alarming, most children recover completely within 4-6 weeks without long-term effects.

Key takeaways

  • Henoch-Schonlein purpura (HSP), also called IgA vasculitis, is an inflammation of small blood vessels that causes a distinctive purple or reddish rash (purpura), joint pain, and sometimes abdominal pain or kidney involvement. It most commonly affects children between 2 and 6 years but can occur in toddlers. HSP often follows an upper respiratory infection. While it looks alarming, most children recover completely within 4-6 weeks without long-term effects.
  • Usually normal when: The purpura rash gradually fading over 2-4 weeks
  • Call your doctor if: Your child develops a non-blanching purpura rash with fever, which needs urgent evaluation to rule out meningococcal disease or sepsis
“Fever itself is not an illness — rather, it is a sign or symptom that the body is fighting an infection. Fever stimulates certain defenses, such as the white blood cells, which attack and destroy invading bacteria.”
— Fever and Your Child, American Academy of Pediatrics (AAP)

Thousands of parents search for this exact thing. You are not alone.

What Parents Should Know

According to AAP, NIH, CDC guidelines, henoch-Schonlein purpura (HSP), also called IgA vasculitis, is an inflammation of small blood vessels that causes a distinctive purple or reddish rash (purpura), joint pain, and sometimes abdominal pain or kidney involvement. It most commonly affects children between 2 and 6 years but can occur in toddlers. HSP often follows an upper respiratory infection. While it looks alarming, most children recover completely within 4-6 weeks without long-term effects. At 0-12 months, hSP is rare in babies under 1 year. Any non-blanching purpura (purple or red spots that do not fade when you press on them) in an infant needs urgent medical evaluation, as it could indicate other serious conditions like meningococcal infection or a bleeding disorder. Do not wait to see if it improves on its own. It is generally considered normal when the purpura rash gradually fading over 2-4 weeks. However, you should contact your pediatrician promptly if your child develops a non-blanching purpura rash with fever, which needs urgent evaluation to rule out meningococcal disease or sepsis.

Sources: [1], [2], [3]

Normal vs. Concerning

Usually Normal
Worth Discussing
The purpura rash gradually fading over 2-4 weeks
Your child develops a non-blanching purpura rash with fever, which needs urgent evaluation to rule out meningococcal disease or sepsis
Joint pain and swelling that come and go and resolve within a few weeks
Your child has severe abdominal pain, vomiting blood, or bloody stool with purpura
Mild, crampy abdominal pain without vomiting blood or severe distress
Your child has decreased urine output, swelling of the face or ankles, or dark/bloody urine, which could indicate kidney involvement
A brief recurrence of rash within the first few months after the initial episode
Your child cannot walk due to severe joint pain and swelling

When to Seek Immediate Care

  • Your child develops a non-blanching purpura rash with fever, which needs urgent evaluation to rule out meningococcal disease or sepsis
  • Your child has severe abdominal pain, vomiting blood, or bloody stool with purpura
  • Your child has decreased urine output, swelling of the face or ankles, or dark/bloody urine, which could indicate kidney involvement
  • Your child cannot walk due to severe joint pain and swelling
  • An infant under 12 months develops any non-blanching rash

By Age

What to expect by age

0-12 months

HSP is rare in babies under 1 year. Any non-blanching purpura (purple or red spots that do not fade when you press on them) in an infant needs urgent medical evaluation, as it could indicate other serious conditions like meningococcal infection or a bleeding disorder. Do not wait to see if it improves on its own.

1-3 years

HSP can occur in toddlers, though it is most common in slightly older children. The classic presentation includes a palpable purpura rash (raised purple or red spots) mainly on the buttocks and legs, joint pain and swelling (especially in the ankles and knees), abdominal pain, and sometimes blood in the urine. The rash does not blanch when pressed. Symptoms often develop 1-3 weeks after a cold or sore throat.

What to Tell Your Pediatrician

  • Describe when you first noticed henoch-schonlein purpura (iga vasculitis) in children and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if your child has a non-blanching purple or red rash on the legs and buttocks.
  • Mention if your child has joint pain and swelling along with a purpura rash.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

What Should You Do?

When to take action

Probably normal when...
  • The purpura rash gradually fading over 2-4 weeks
  • Joint pain and swelling that come and go and resolve within a few weeks
  • Mild, crampy abdominal pain without vomiting blood or severe distress
  • A brief recurrence of rash within the first few months after the initial episode
Mention at your next visit when...
  • Your child has a non-blanching purple or red rash on the legs and buttocks
  • Your child has joint pain and swelling along with a purpura rash
  • Your child has mild abdominal pain with the rash
  • Your child has had HSP and you notice blood or protein in the urine on follow-up testing
Act now when...
  • Your child develops a non-blanching purpura rash with fever, which needs urgent evaluation to rule out meningococcal disease or sepsis
  • Your child has severe abdominal pain, vomiting blood, or bloody stool with purpura
  • Your child has decreased urine output, swelling of the face or ankles, or dark/bloody urine, which could indicate kidney involvement
  • Your child cannot walk due to severe joint pain and swelling
  • An infant under 12 months develops any non-blanching rash

What You Can Do at Home

  • Keep track of when you notice henoch-schonlein purpura (iga vasculitis) in children — noting the time of day, duration, and any triggers can help your pediatrician.
  • Remember that the purpura rash gradually fading over 2-4 weeks — this is generally within the range of normal.
  • At 0-12 months, focus on observation rather than intervention unless your pediatrician advises otherwise.
  • Follow any care instructions from your pediatrician. Keep a written log of symptoms to bring to appointments.
  • While monitoring at home, seek immediate care if your child develops a non-blanching purpura rash with fever, which needs urgent evaluation to rule out meningococcal disease or sepsis.

Petechiae (Tiny Red Dots) on My Baby

Petechiae are tiny red, purple, or brown dots caused by broken blood vessels just under the skin. While they can appear after vigorous crying, coughing, or vomiting in healthy babies, they can also signal serious conditions. Always contact your pediatrician if you notice petechiae, especially if they appear suddenly or are widespread.

Baby Bruises Easily - When to Worry

Bruising in babies and toddlers is extremely common once they become mobile. Shins, forehead, knees, and elbows are the most typical locations, matching where active children bump into things. Bruising in these "bony prominence" areas is expected and normal. Bruising becomes more concerning when it appears in unusual locations (torso, back, cheeks, neck, buttocks), in a baby who is not yet mobile, or when bruises appear without any known injury. In these cases, your pediatrician may recommend bloodwork to check for bleeding disorders.

Baby Hives (Urticaria)

Hives are raised, red, itchy welts that can appear suddenly on your baby's skin. They are most often caused by a viral infection or an allergic reaction to food, medication, or an insect bite. While they can look alarming, hives are usually harmless and resolve on their own, though any breathing difficulty needs immediate emergency care.

My Baby Has a Fever and a Rash

The combination of fever and rash in a baby is very common and is usually caused by a viral infection such as roseola, hand-foot-and-mouth disease, or other viral exanthems. A rash that appears after a fever breaks (as in roseola) is typically benign. However, certain fever-rash combinations, particularly non-blanching purple spots (petechiae or purpura), require immediate medical attention.

Triage

Rash Decision Tree

Identify common rashes and determine when to seek care.

Guide

When to Call the Doctor

General guide on when to call the pediatrician, visit urgent care, or go to the ER.

Frequently asked questions

Is henoch-schonlein purpura (iga vasculitis) in children normal?
Henoch-Schonlein purpura (HSP), also called IgA vasculitis, is an inflammation of small blood vessels that causes a distinctive purple or reddish rash (purpura), joint pain, and sometimes abdominal pain or kidney involvement. It most commonly affects children between 2 and 6 years but can occur in toddlers. HSP often follows an upper respiratory infection. While it looks alarming, most children recover completely within 4-6 weeks without long-term effects.
When should I call the doctor about henoch-schonlein purpura (iga vasculitis) in children?
Your child develops a non-blanching purpura rash with fever, which needs urgent evaluation to rule out meningococcal disease or sepsis Your child has severe abdominal pain, vomiting blood, or bloody stool with purpura Your child has decreased urine output, swelling of the face or ankles, or dark/bloody urine, which could indicate kidney involvement
When is henoch-schonlein purpura (iga vasculitis) in children normal?
The purpura rash gradually fading over 2-4 weeks Joint pain and swelling that come and go and resolve within a few weeks Mild, crampy abdominal pain without vomiting blood or severe distress
What causes henoch-schonlein purpura (iga vasculitis) in children?
Henoch-Schonlein purpura (HSP), also called IgA vasculitis, is an inflammation of small blood vessels that causes a distinctive purple or reddish rash (purpura), joint pain, and sometimes abdominal pain or kidney involvement. It most commonly affects children between 2 and 6 years but can occur in toddlers. HSP often follows an upper respiratory infection. While it looks alarming, most children recover completely within 4-6 weeks without long-term effects. Common explanations include: The purpura rash gradually fading over 2-4 weeks. Joint pain and swelling that come and go and resolve within a few weeks.
What should I mention to my pediatrician about henoch-schonlein purpura (iga vasculitis) in children?
You should mention henoch-schonlein purpura (iga vasculitis) in children at your next visit if: Your child has a non-blanching purple or red rash on the legs and buttocks. Your child has joint pain and swelling along with a purpura rash. Your child has mild abdominal pain with the rash.
Is henoch-schonlein purpura (iga vasculitis) in children normal at 0-12 months?
HSP is rare in babies under 1 year. Any non-blanching purpura (purple or red spots that do not fade when you press on them) in an infant needs urgent medical evaluation, as it could indicate other serious conditions like meningococcal infection or a bleeding disorder. Do not wait to see if it improves on its own.
Is henoch-schonlein purpura (iga vasculitis) in children normal at 1-3 years?
HSP can occur in toddlers, though it is most common in slightly older children. The classic presentation includes a palpable purpura rash (raised purple or red spots) mainly on the buttocks and legs, joint pain and swelling (especially in the ankles and knees), abdominal pain, and sometimes blood in the urine. The rash does not blanch when pressed. Symptoms often develop 1-3 weeks after a cold or sore throat.
Should I go to the ER for henoch-schonlein purpura (iga vasculitis) in children?
Seek emergency care if your child develops a non-blanching purpura rash with fever, which needs urgent evaluation to rule out meningococcal disease or sepsis, or if your child has severe abdominal pain, vomiting blood, or bloody stool with purpura. When in doubt, call your pediatrician's after-hours line for guidance.
Does henoch-schonlein purpura (iga vasculitis) in children go away on its own?
In many cases, henoch-schonlein purpura (iga vasculitis) in children resolves on its own, especially when the purpura rash gradually fading over 2-4 weeks.
AAPNIHCDC

References

  1. [1]American Academy of Pediatrics. Henoch-Schonlein Purpura. Pediatrics in Review. AAP
  2. [2]National Institute of Diabetes and Digestive and Kidney Diseases. IgA Vasculitis. NIH
  3. [3]Centers for Disease Control and Prevention. Vasculitis. CDC

Doctor Visit Checklist

Bring this checklist to your next pediatrician visit to discuss Henoch-Schonlein Purpura (IgA Vasculitis) in Children.

Things to mention

  • Describe when you first noticed henoch-schonlein purpura (iga vasculitis) in children and how it has changed over time.
  • Note your baby's current age and which age-specific patterns you are seeing.
  • Mention if your child has a non-blanching purple or red rash on the legs and buttocks.
  • Mention if your child has joint pain and swelling along with a purpura rash.
  • Let your doctor know if you have noticed any related concerns, such as changes in feeding, sleep, or movement patterns.
  • Bring a list of any questions or observations you want to discuss at the appointment.

Observations to share

  • Your child has a non-blanching purple or red rash on the legs and buttocks
  • Your child has joint pain and swelling along with a purpura rash
  • Your child has mild abdominal pain with the rash

Urgent signs to report immediately

  • Your child develops a non-blanching purpura rash with fever, which needs urgent evaluation to rule out meningococcal disease or sepsis
  • Your child has severe abdominal pain, vomiting blood, or bloody stool with purpura
  • Your child has decreased urine output, swelling of the face or ankles, or dark/bloody urine, which could indicate kidney involvement

My notes

From ismybabyalright.com — free, evidence-based baby health guides

All content follows our editorial policy and is reviewed against published clinical guidelines.

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Related Resources

Rash TriageWell-Baby Visit PrepMedicine Dosage CalculatorEmergency ContactsBaby Tracker

Bottom line

Most cases of henoch-schonlein purpura (iga vasculitis) in children are normal. Talk to your pediatrician if your child develops a non-blanching purpura rash with fever, which needs urgent evaluation to rule out meningococcal disease or sepsis.

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.

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Petechiae (Tiny Red Dots) on My Baby

Petechiae are tiny red, purple, or brown dots caused by broken blood vessels just under the skin. While they can appear after vigorous crying, coughing, or vomiting in healthy babies, they can also signal serious conditions. Always contact your pediatrician if you notice petechiae, especially if they appear suddenly or are widespread.

Baby Bruises Easily - When to Worry

Bruising in babies and toddlers is extremely common once they become mobile. Shins, forehead, knees, and elbows are the most typical locations, matching where active children bump into things. Bruising in these "bony prominence" areas is expected and normal. Bruising becomes more concerning when it appears in unusual locations (torso, back, cheeks, neck, buttocks), in a baby who is not yet mobile, or when bruises appear without any known injury. In these cases, your pediatrician may recommend bloodwork to check for bleeding disorders.

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The combination of fever and rash in a baby is very common and is usually caused by a viral infection such as roseola, hand-foot-and-mouth disease, or other viral exanthems. A rash that appears after a fever breaks (as in roseola) is typically benign. However, certain fever-rash combinations, particularly non-blanching purple spots (petechiae or purpura), require immediate medical attention.

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