Differential Diagnosis

Disease/Condition Differentiating Signs/Symptoms Differentiating Tests

Idiopathic Rash of ITP may also have
Platelet level is low in ITP, but
thrombocytopenic petechiae. Arthralgias and
normal in HSP.
purpura (ITP) abdominal pain are uncommon.
Skin biopsy may show
Hypersensitivity
Usually no renal involvement. leukocytoclastic vasculitis, but no
vasculitis
IgA deposition.
Predominance of deposition of IgA
on biopsy characterizes HSP.

May have similar clinical features Laboratory evaluation including

Granulomatosis with
to HSP, but uncommon in antinuclear antibodies, antineutrophil
polyangiitis
children. cytoplasmic antibodies, and
complement levels can help
differentiate HSP from other
vasculitides.
Predominance of deposition of IgA
on biopsy characterizes HSP.

May have similar clinical features Laboratory evaluation including

Systemic lupus
to HSP, but uncommon in antinuclear antibodies, antineutrophil
erythematosus (SLE)
children. cytoplasmic antibodies, and
complement levels can help
differentiate HSP from other
vasculitides.
Predominance of deposition of IgA
May have similar clinical features
on biopsy characterizes HSP.
to HSP; however, the rash in
rheumatoid arthritis, if present, is
Rheumatoid arthritis Rheumatoid factor has been reported
usually not palpable purpura.
in both rheumatoid arthritis and HSP,
Rheumatoid arthritis is seen more
therefore making them difficult to
often in adults.
distinguish.
Predominance of deposition of IgA
May have similar clinical features
on biopsy characterizes HSP.
to HSP; however, the rash in
Increased antistreptolysin-O antibody
Rheumatic fever rheumatic fever is erythema
titers have been reported in both
marginatum, and not palpable
rheumatic fever and HSP, therefore
purpura.
making them difficult to distinguish.
Abnormal coagulation studies and
Meningococcal May have similar clinical features; low platelet counts are seen in
septicemia rash may also have petechiae. septicemia. These studies are normal
in HSP.
 Disease/Condition Differentiating Signs/Symptoms Differentiating Tests
Hemolytic anemia, with elevated
reticulocyte counts and low
May have similar clinical features; haptoglobin levels, and low platelets
Hemolytic uremic
rash may also have petechiae. are seen in HUS. Stool studies may
syndrome (HUS)
Diarrhea is common in HUS. be helpful in HUS; these studies are
normal in HSP and abnormal in
HUS.
Predominance of deposition of IgA
on biopsy characterizes HSP.

May have similar clinical features Laboratory evaluation including

Polyarteritis nodosa to HSP, but uncommon in
children.
Rash, abdominal pain, and arthritis
are generally not present. Patients
IgA nephropathy
are usually between 20 to 40 years
of age.
antinuclear antibodies, antineutrophil
cytoplasmic antibodies, and
complement levels can help
differentiate HSP from other
vasculitides.
Renal biopsy shows similar findings
with IgA nephropathy and HSP.
However, patients with IgA
nephropathy do not have the other
clinical manifestations of HSP.
Predominance of deposition of IgA
on biopsy characterizes HSP.

May have similar clinical features Laboratory evaluation including

Other vasculitides to HSP, but uncommon in
children.
antinuclear antibodies, antineutrophil
cytoplasmic antibodies, and
complement levels can help
differentiate HSP from other
vasculitides.