presentation is typically with skin purpura. Some patients also develop abdominal pain, gastrointestinal bleeding, arthropathy and renal failure due to IgA nephropathy. Nephritis occurs in 50–80% adults and 20–40% children , who might present with an isolated haematuria, proteinuria, acute nephritis or nephrotic syndrome. In adulthood, Henoch–Schonlein purpura is a more severe clinical syndrome with a higher frequency of diarrhoea and renal involvement and with a worse outcome . Although Henoch–Schonlein purpura usually resolves spontaneously, there are concerns about the development of renal failure which is rare. Evidence for treatment is limited but selected patients may benefit from steroids [111,113]. There is a growing trend in inflammatory diseases to use specific biological therapy designed to interfere with individual cytokines or pathways.