DEAR DR. DONOHUE: My son, four weeks ago, broke out in bruises on his legs and buttocks. He complained of a headache and painful ankles and knees. We wasted no time in getting him to an emergency room, and the examining doctor had him immediately admitted to the hospital. After a few days of tests, we learned he had Henoch-Schonlein purpura. He’s out of the hospital and almost back to normal. Will he have any long-range problems from this? – R.C.

ANSWER: Your son had an illness that is mostly confined to children between the ages of 2 and 11. The basic problem is blood vessel inflammation. The inflamed vessels leak blood, which produces bruises. Joint pain is another cardinal symptom, and abdominal pain is another common complaint.

All of this stems from the production of antibodies that attack blood vessels. Antibodies are supposed to work for us. Here they work against us. A prior infection with the strep germ (or many other germs) appears to trigger the immune system into production of the vessel-damaging antibodies.

If the process is not severe, making the child comfortable is the goal of treatment. When joints hurt, anti-inflammatory drugs can usually quiet them. If the process is of greater magnitude, cortisone drugs are the drugs of choice.

Most children get over the illness in four to six weeks.

The future picture for Henoch-Schonlein children is usually excellent. A few, however, can have kidney involvement that persists long after the bruising, stomach pain and joint pain have stopped.

Even though children are the majority of Henoch-Schonlein patients, it can happen to adults.

DEAR DR. DONOHUE: From time to time I would have very dark urine. It looked like Tabasco sauce. I had many tests, and the final result was that I have something called Berger’s disease. I would like to know what bearing this has on my life expectancy. I have two small children. – F.F.

ANSWER: Berger’s disease is a pretty common kidney affliction. It also goes by the name of IgA nephropathy (nuh-FROP-uh-thee). “Nephropathy” is a borrowed Greek word meaning kidney disease. The “IgA” of the name indicates that a particular antibody, IgA antibody, is sticking to the kidneys’ filtering stations and causing them to operate at less-than-optimum efficiency.

The activity of this illness can be determined by the amount of protein in the urine. If urine protein is not great, then nothing more than checking it at scheduled intervals need be done.

Serious kidney malfunction calls for cortisone drug treatment.

Nearly 40 percent of patients develop high blood pressure within about 10 years. A rise in blood pressure must be treated aggressively, since it can add to the kidney damage brought on by the IgA antibodies.

Sometimes fish oils have a beneficial effect on this illness.

I would like to give you a definite statement of what the future holds in store for you. Apparently your kidneys are working well, since you do not mention taking any medicine. Even should the worst occur – kidney failure – all is not lost. Kidney transplants permit most to have a normal life expectancy.

DEAR DR. DONOHUE: I love salt and salty foods. My wife says I am going to have high blood pressure because I eat so much salt. Will I? – F.M.

ANSWER: For health, people need one-tenth of a teaspoon of salt daily. In this part of the world, we get many times that amount without ever using a salt shaker, so salty is the food we eat.

A few unusual illnesses feature salt-craving. One of them is Addison’s disease, where the adrenal glands go kaput and fail to make hormones that keep the body’s salt level where it should be. I am not suggesting you have Addison’s disease. It brings other, dramatic symptoms that would make you aware of it.

Not everyone is sensitive to the blood pressure rise that salt can generate. However, it would be a good idea to reduce the amount of salt you’re getting. With age, blood pressure, even in the healthiest people, tends to rise, and your infatuation with salt puts you at greater risk for a blood pressure rise.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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