Steroids should be considered only in the setting of severe gastrointestinal or renal involvement or painful cutaneous edema.

HSP is a vasculitis almost always affecting children younger than 20 years of age. It commonly presents as abdominal pain with nonthrombo- cytopenic palpable purpura on the lower extremities and buttocks following a viral upper respiratory infection. In most cases, it is a self-limited problem, resolving without intervention. Because of potential renal and serious gastrointestinal complications, careful monitoring is warranted. Renal complications can range from mild hematuria to glomerulonephritis. Gastrointestinal complications can range from self-limited abdominal pain to intussusception. Renal impairment is the most significant long-term complication in children with HSP. After careful study, children with a normal urinalysis at diagnosis are not at increased risk for chronic renal problems. On the other hand, children with nephrotic or nephritic syndrome at presentation have more than a 10-fold increase in long-term renal sequelae. These findings raise the question: Can anything be done to prevent long-term complications of HSP?