Çocukluk çağı vasküliti ile takipli hastaların demografik verileri ve klinik izlemleri
Year 2024,
Volume: 7 Issue: 2, 214 - 218, 30.06.2024
Kübra Uçak
,
Nihal Şahin
,
Hafize Emine Sönmez
Abstract
Giriş:
Vaskülitler, damar duvarlarının iltihaplanmasıyla karakterize bir grup hastalıktır. Vaskülitlerin çoğu belli büyüklükteki damarlarda inflamasyon yapar ve belirli hedef organlarda tutulum yaparlar. Bu çalışmada kliniğimizde vaskülit tanısı almış çocuk hastaların verilerini inceleyerek bölgemizdeki çocuk hekimlerinin bu konuda farkındalığını arttırmayı amaçladık.
Yöntem:
Çalışmada vaskülit tanısı alan 0-18 yaş arası hastalar incelendi. Vaskülit alt grupları, hastaların demografik verileri klinik bulguları ve tanı anındaki laboratuvar bulguları geriye dönük olarak tarandı.
Bulgular:
Çalışmaya dahil edilen 95 hastadan 78’i (%83) Henoch-Schönlein purpurası/Immunoglobulin A vasküliti (HSP/IgAV), 8’i (%8,4) Kawasaki hastalığı (KH), 6’sı (%6,4) Behçet Hastalığı (BH), 1’i (%1,1) eozinofilik granülomatöz polianjiyit/Churg-Strauss sendromu ve 1’i (%1,1) de santral sinir sistemi (SSS) vasküliti tanısı aldı. Yaş aralıklarına göre dağılımına bakıldığında; KH bebeklik ve oyun çocuğu döneminde daha sıkken BH sıklığı ergenlik döneminde artmaktaydı. Ancak HSP/IgAV bebeklik dönemi hariç her yaş grubunda en sık görülen vaskülit türüydü.
Sonuç:
Çocukluk çağı vaskülitleri klinik olarak tanınması oldukça güçtür ve bu konuda yapılmış epidemiyolojik çalışmalar oldukça yetersizdir. Sonuçlarımız bu hastalarla günlük pratiğinde karşılaşan çocuk hekimlerinin farkındalığı arıtmaya yardımcı olabilir.
Ethical Statement
Kocaeli Üniversitesi Tıp Fakültesi Klinik Araştırmalar Etik Kurulu onayı alınmıştır. Tüm prosedürler, kurumsal ve/veya ulusal araştırma komitesinin etik standartlarına ve 1964 Helsinki Bildirgesi’ne uygun olarak gerçekleştirilmiştir. (Onay numarası ve tarihi: GOKAEK-2023/11.20, 16.Haziran.2023).
Supporting Institution
yok
References
- Eleftheriou D, Batu ED, Ozen S, Brogan PA. Vasculitis in children. Nephrol Dial Transplant. Apr 2015;30 Suppl 1:i94-103. DOI:10.1093/ndt/gfu393
- Demir S, Sonmez HE, Ozen S. Vasculitis: Decade in Review. Curr Rheumatol Rev. 2019;15(1):14-22. DOI:10.2174/1573397114666180726093731
- Trindade TS, Morais CG, Maia A, Rodrigues M, Brito I. Demographic and clinical features of pediatric vasculitis: a single-center study. ARP Rheumatol. Jan-Mar 2023;2(1):30-40. PMID: 36739540.
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- Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. Jan 2013;65(1):1-11. DOI:10.1002/art.37715
- Malleson PN, Fung MY, Rosenberg AM. The incidence of pediatric rheumatic diseases: results from the Canadian Pediatric Rheumatology Association Disease Registry. J Rheumatol. Nov 1996;23(11):1981-1987. PMID: 8923379.
- Bowyer S, Roettcher P. Pediatric rheumatology clinic populations in the United States: results of a 3 year survey. Pediatric Rheumatology Database Research Group. J Rheumatol. Nov 1996;23(11):1968-1974. PMID: 8923377.
- Ozen S, Pistorio A, Iusan SM, et al. EULAR/PRINTO/PRES criteria for Henoch-Schonlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis. May 2010;69(5):798-806. DOI:10.1136/ard.2009.116657
- Newburger JW, Takahashi M, Gerber MA, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. Oct 26 2004;110(17):2747-2771. DOI:10.1161/01.CIR.0000145143.19711.78
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- Ross E. Petty DAC. Vasculitis and Its Classification. In: Ross E. Petty RML, Carol B. Lindsley, Lucy R. Wedderburn, ed. TEXTBOOK OF PEDIATRIC RHEUMATOLOGY, SEVENTH EDITION. Vol 4. Philadelphia: Elsevier; 2016:448-451
- Ozen S, Bakkaloglu A, Dusunsel R, et al. Childhood vasculitides in Turkey: a nationwide survey. Clin Rheumatol. Feb 2007;26(2):196-200. DOI:10.1007/s10067-006-0266-6
- Sonmez HE, Armagan B, Ayan G, et al. Polyarteritis nodosa: lessons from 25 years of experience. Clin Exp Rheumatol. Mar-Apr 2019;37 Suppl 117(2):52-56. PMID: 30418125.
- Leung AKC, Barankin B, Leong KF. Henoch-Schonlein Purpura in Children: An Updated Review. Curr Pediatr Rev. 2020;16(4):265-276. DOI:10.2174/1573396316666200508104708
- Ozen S, Eroglu FK. Pediatric-onset Behcet disease. Curr Opin Rheumatol. Sep 2013;25(5):636-642. DOI:10.1097/BOR.0b013e328363ea8b
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- Oni L, Sampath S. Childhood IgA Vasculitis (Henoch Schonlein Purpura)-Advances and Knowledge Gaps. Front Pediatr. 2019;7:257. DOI:10.3389/fped.2019.00257
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Demographic data and clinical follow-up of patients with childhood vasculitis
Year 2024,
Volume: 7 Issue: 2, 214 - 218, 30.06.2024
Kübra Uçak
,
Nihal Şahin
,
Hafize Emine Sönmez
Abstract
Objective
Vasculitides are distinguished by the inflammation of blood vessel walls. These conditions affect vessels of particular sizes and specific target organs. Herein, we aimed to increase the awareness of pediatricians concerning vasculitides by conducting a retrospective analysis of patients.
Methods
We conducted an examination of individuals aged 0-18 years who had been diagnosed with vasculitis. Subgroups of vasculitis, demographic, clinical, and laboratory findings of patients were reviewed retrospectively.
Results
Among the 95 patients included in the study, Henoch-Schönlein purpura/Immunoglobulin A vasculitis (HSP/IgAV) was the predominant vasculitis, afflicting 78 (83%) of the patients. Kawasaki disease (KD) was identified in 8 patients (8.4%), while Behçet's Disease (BD) was diagnosed in 6 (6.4%). One patient (1.1%) presented with eosinophilic granulomatosis polyangiitis/Churg-Strauss syndrome. One patient (1.1%) was diagnosed with central nervous system vasculitis. In terms of age distribution, KD was more prevalent in infancy and early childhood while the incidence of BD rises during adolescence. However, HSP/IgAV emerged as the most common vasculitis type across all age groups, except for infancy.
Conclusion
The clinical diagnosis of vasculitis in children can be particularly challenging. Moreover, there is a notable lack of comprehensive epidemiological studies in this area. The outcomes of our study have the potential to augment the awareness of pediatricians who routinely care for children with vasculitis in their clinical practice.
References
- Eleftheriou D, Batu ED, Ozen S, Brogan PA. Vasculitis in children. Nephrol Dial Transplant. Apr 2015;30 Suppl 1:i94-103. DOI:10.1093/ndt/gfu393
- Demir S, Sonmez HE, Ozen S. Vasculitis: Decade in Review. Curr Rheumatol Rev. 2019;15(1):14-22. DOI:10.2174/1573397114666180726093731
- Trindade TS, Morais CG, Maia A, Rodrigues M, Brito I. Demographic and clinical features of pediatric vasculitis: a single-center study. ARP Rheumatol. Jan-Mar 2023;2(1):30-40. PMID: 36739540.
- Cannon L, Wu EY. Recent Advances in Pediatric Vasculitis. Rheum Dis Clin North Am. Nov 2021;47(4):781-796. DOI:10.1016/j.rdc.2021.07.007
- Jennette JC, Falk RJ, Bacon PA, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum. Jan 2013;65(1):1-11. DOI:10.1002/art.37715
- Malleson PN, Fung MY, Rosenberg AM. The incidence of pediatric rheumatic diseases: results from the Canadian Pediatric Rheumatology Association Disease Registry. J Rheumatol. Nov 1996;23(11):1981-1987. PMID: 8923379.
- Bowyer S, Roettcher P. Pediatric rheumatology clinic populations in the United States: results of a 3 year survey. Pediatric Rheumatology Database Research Group. J Rheumatol. Nov 1996;23(11):1968-1974. PMID: 8923377.
- Ozen S, Pistorio A, Iusan SM, et al. EULAR/PRINTO/PRES criteria for Henoch-Schonlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis. May 2010;69(5):798-806. DOI:10.1136/ard.2009.116657
- Newburger JW, Takahashi M, Gerber MA, et al. Diagnosis, treatment, and long-term management of Kawasaki disease: a statement for health professionals from the Committee on Rheumatic Fever, Endocarditis and Kawasaki Disease, Council on Cardiovascular Disease in the Young, American Heart Association. Circulation. Oct 26 2004;110(17):2747-2771. DOI:10.1161/01.CIR.0000145143.19711.78
- Kone-Paut I, Shahram F, Darce-Bello M, et al. Consensus classification criteria for paediatric Behcet's disease from a prospective observational cohort: PEDBD. Ann Rheum Dis. Jun 2016;75(6):958-964. DOI:10.1136/annrheumdis-2015-208491
- Masi AT, Hunder GG, Lie JT, et al. The American College of Rheumatology 1990 criteria for the classification of Churg-Strauss syndrome (allergic granulomatosis and angiitis). Arthritis Rheum. Aug 1990;33(8):1094-1100. DOI:10.1002/art.1780330806
- Ross E. Petty DAC. Vasculitis and Its Classification. In: Ross E. Petty RML, Carol B. Lindsley, Lucy R. Wedderburn, ed. TEXTBOOK OF PEDIATRIC RHEUMATOLOGY, SEVENTH EDITION. Vol 4. Philadelphia: Elsevier; 2016:448-451
- Ozen S, Bakkaloglu A, Dusunsel R, et al. Childhood vasculitides in Turkey: a nationwide survey. Clin Rheumatol. Feb 2007;26(2):196-200. DOI:10.1007/s10067-006-0266-6
- Sonmez HE, Armagan B, Ayan G, et al. Polyarteritis nodosa: lessons from 25 years of experience. Clin Exp Rheumatol. Mar-Apr 2019;37 Suppl 117(2):52-56. PMID: 30418125.
- Leung AKC, Barankin B, Leong KF. Henoch-Schonlein Purpura in Children: An Updated Review. Curr Pediatr Rev. 2020;16(4):265-276. DOI:10.2174/1573396316666200508104708
- Ozen S, Eroglu FK. Pediatric-onset Behcet disease. Curr Opin Rheumatol. Sep 2013;25(5):636-642. DOI:10.1097/BOR.0b013e328363ea8b
- Karadag SG, Tanatar A, Sonmez HE, et al. The clinical spectrum of Henoch-Schonlein purpura in children: a single-center study.1 Clin Rheumatol. Jun 2019;38(6):1707-1714. DOI:10.1007/s10067-019-04460-1
- Oni L, Sampath S. Childhood IgA Vasculitis (Henoch Schonlein Purpura)-Advances and Knowledge Gaps. Front Pediatr. 2019;7:257. DOI:10.3389/fped.2019.00257
- Demir F, Sonmez HE, Baglan E, et al. Cluster analysis of paediatric Behcet's disease: Data from The Pediatric Rheumatology Academy-Research Group. Mod Rheumatol. Apr 13 2023;33(3):574-578. DOI:10.1093/mr/roac044
- Sönmez HE, Bilginer Y, Özen S. Systemic Vasculitis in Adolescence and Young Adulthood. İçinde: McDonagh Janet E, Tattersall Rachel S, ed. Adolescent and Young Adult Rheumatology In Clinical Practice. 1. Baskı. Springer Nature, Switzerland, Inc; 2019:131-145