Volume 187, Issue S1 p. 193
Abstract
Free Access

H20: Henoch–Schönlein purpura: what’s in a name?

First published: 05 July 2022

Mun Wai Lam, Sukhjit Kaur Dhariwal and Stephen Orpin

University Hospitals Birmingham, Birmingham, UK

Henoch–Schönlein purpura (HSP), now known as IgA vasculitis, is a leucocytoclastic vasculitis affecting small blood vessels predominantly found in the paediatric population. In the 1860s, the disease was named after Eduard Heinrich Henoch, a German paediatrician and his mentor Johann Lukas Schönlein. However, it was first described in the early eighteenth century by English physician William Heberden and Dermatologist Robert Willan, founding father of modern English dermatology, so perhaps we should call it Heberden-Willan disease? Johann Schönlein was a professor of medicine at the Royal Charite Hospital in Berlin, where he trained Eduard Henoch. Schönlein’s contribution to clinical medicine, especially in the field of paediatrics, is well recognized. In 1837, he unravelled the association of arthritis and nonthrombocytopenic purpura, especially in children and hence the name Schönlein disease. Eduard Henoch trained in medicine with Schönlein, as well as his uncle Moritz Romberg, in Berlin. He graduated in medicine in 1843 and travelled to Italy and Switzerland on a sort of academic ‘grand tour’. He subsequently published books in paediatrics, the best known of which, Lectures on Children’s Diseases, first appeared in 1889. His journey as a medical practitioner saw him as a lecture in internal medicine, director of the outpatient paediatric clinic and senior lecturer in paediatrics. Ultimately, he was rewarded with his own chair when made associate professor at the university for his work. In 1868 he discovered the association of gastrointestinal symptoms such as abdominal pain and renal involvement with nonthrombocytopenic purpura. The relationship was established following a case he attended in a 15-year-old boy, hence the term Henoch purpura or Henoch disease. Following that, Schönlein–Henoch purpura, with Schönlein describing the disease first, and Henoch–Schönlein purpura have been used interchangeably to acknowledge the contribution of both in describing the disorder. Eduard Glanzmann, a Swiss paediatrician, went on to describe an allergic component in HSP in 1920. With a better understanding of the pathophysiology of the disease over the years, in 2012, the International Chapel Hill Consensus Conference Nomenclature of Vasculitides renamed HSP IgA vasculitis. Prior to this, the disease was more often known as Henoch–Schönlein purpura rather than the reverse. As Johann Schönlein was the first to notice the systemic involvement in the disease, should medical professionals have been calling it Schönlein–Henoch purpura all along?

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