Henoch-Schönlein Purpura

Q:  I really enjoy your health column. My question is about "Henoch-Schönlein Purpura" (HSP) which I never heard of until my grandson at age 3 was diagnosed with it. While he was being monitored for HSP, his blood sugar tested high. He hasn't had any recurrence of HSP but now is a type I diabetic. His endocrinologist thinks his diabetes was most likely caused from a virus since there is no history of type I diabetes in the birth parents (he has a twin brother who is okay). Would you please explain HSP to me and is there a possibility that this caused the diabetes?

A:  Henoch-Schonlein purpura is a disease that may affect any age group but is usually seen in children. It is characterized by purpura, which are dark purplish-red patches of skin on the buttocks and lower legs. In addition the patient may have joint pain, abdominal pain, and kidney involvement. The immune system goes awry and starts forming complexes in the blood that leads to hemorrhage of the blood vessels in the skin, joints and other organs. Viruses and other infections, drugs, foods, insect bites, and immunization have all been implicated as possible reasons the immune system gets "messed up."

Fortunately, most children, like your grandson, recover completely. HSP itself is not known to be a cause of diabetes, but there could be a link between a virus that triggered both the HSP and the Type I diabetes. There is increasing evidence to suggest that there is viral destruction of the pancreas cells that produce insulin in Type I diabetics (juvenile-onset). This is not the case in adult-onset Type II diabetes which usually develops in people over the age of forty who are obese and have a strong family history of diabetes.

"Dear Doctor" is a compilation of patient questions answered by doctors from the Medical College of Wisconsin.