several weeks Gross hematuria will diminish rapidly, though microscopic hematuria may persist for months or longer Proteinuria typically improves quickly and resolves within months, although some patients may have mild proteinuria years after the initial illness Studies evaluating the long-term prognosis reveal residual signs of chronic kidney damage in some patients decades after the initial course This underscores the importance of routine monitoring of blood pressure and urinalyses as part of health maintenance in those who have a history of APSGN Henoch–Schönlein Purpura Goals of Treatment The goals of treatment for Henoch–Schönlein purpura (HSP) are generally supportive Analgesics and anti-inflammatory medications such as NSAIDs may help alleviate associated arthralgias and arthritis Patients may require parenteral hydration, especially in the setting of gastrointestinal manifestations Children with abdominal pain should be evaluated and monitored for surgical complications (see Chapter 53 Pain: Abdomen ) HSP-associated nephritis rarely requires specific interventions If there is concern for significant AKI, a nephrologist should be consulted to help determine further evaluation and management CLINICAL PEARLS AND PITFALLS Nephritis secondary to HSP most often presents within the first weeks but may present up to months after the initial presentation of rash and arthritis Patients with suspected HSP should undergo urinalysis to evaluate for hematuria Care is generally supportive Clinical Considerations Clinical recognition Immunoglobulin A vasculitis, more commonly known as HSP, is an IgA-mediated multisystem small-vessel vasculitis predominantly affecting the skin, joints, gastrointestinal tract, and kidneys Though HSP can occur at any age, most cases affect children between and