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Henoch-Schönlein Purpura in the Children: The evaluation retrospective of 50 patients

Year 2010, Volume: 15 Issue: 1, 27 - 30, 01.02.2010

Abstract

Objective: Henoch-Schönlein purpura is a systemic vasculitis which mainly affects the children. We aimed to evaluate the epidemiologic and clinical features of the children with diagnosis of Henoch-Schönlein Purpura followed up in our clinic. Materials and Methods: The epidemiological, clinical and laboratory findings, and the data about treatment of all patients with diagnosis of Henoch-Schönlein Purpura were collected by reviewing medical files. Results: 50 children (27 males, 23 females) aged between 1.5-16.5 years included in the study. The mean age of the patients was 7.9±3.6 years. Purpura was the most common finding seen in all patients. The joint involvement and gastrointestinal involvement occurred in 92 % and 62 % of these patients respectively. Renal involvement occurred in 10 patients (20 %), one of them had developed severe nephropathy. The most frequent laboratory abnormalities were leukocytosis (78 %), high erythrocyte sedimentation rate (48 %) and hyper IgA (26 %). Conclusion: Epidemiological and clinical findings of the patients are similar to those in the literature. Although severe nephropathy was found in a small percentage of the children, the prognosis was usually excellent.

References

  • Cassidy JT, Petty RE. Leukocytoclastic vasculitis. In: Cassidy JT, Petty RE, editors. Textbook of pediatric Rheumatology. 5th ed. W.B. Saunders Co. Philadelphia. 2005, p.496-501.
  • Peru H, Soylemezoglu O, Bakkaloglu SA, et al. Henoch Schonlein purpura in chilhood: clinical analysis of 254 cases over a 3-year period. Clin Rheumatol 2008; 27: 1087-1092.
  • Lahita RG. Influence of age on Henoch Schönlein purpura. Lancet 1997; 350:1116-1117.
  • Szer IS. Henoch- Schönlein purpura: when and how to treat? J Rheumatol 1996; 23:1661-1665.
  • Ronkainen J, Nuutinen M, Koskimies O. The adult kidney 24 years after childhood Henoch.Schönlein purpura: a retrospective cohort study. Lancet 2002; 360:666-700.
  • Ronkainen J, Ala-Houhala M, Huttunen NP, et al. Outcome of Henoch.Schönlein nephritis with nephrotic-range proteinuria. Clin Nephrol 2003; 60:80-84.
  • Goldstein AR, White RH, Akuse R, Chantler C. Long term followup of childhood Henoch.Schönlein nephritis. Lancet 1992; 339:280-282.
  • Ozen S, Ruperto N, Dillon MJ, et al. EULAR/PReS Endorsed consensus criteria for the classification of childhood vasculites. Ann Rheum Dis 2006; 65: 936-941.
  • Tizard EJ. Henoch-Schönlein purpura. Arch Dis Child 1999; 89: 380-383.
  • Inal A, Yılmaz M, Kendirli SG, et al. Henoch-Schönlein purpurası tanısı olan çocukların klinik özellikleri. Erciyes Tıp Dergisi 2009; 31: 153-161.
  • Saulsbury FT. Henoch Schönlein purpura in children: report of 100 patients and review of the literature. Medicine 1999; 78:395-409.
  • Sano H, Izumida M, Shimizu H, Ogawa Y. Risk factors on renal involvement and significant proteinuria in Henoch Schönlein purpura. Eur J Pediatr 2002; 161:196-201.
  • Calvino MC, Llorca J, Garcia-Porrua C, et al. Henoch Schönlein purpura in children from northwestern Spain: a 20year epidemiologic and clinical study. Medicine 2001; 80:279-290.
  • Abdel-Al YK, Hejazi Z, Majeed HA. Henoch Schönlein purpura in Arab children. Analysis of 52 cases. Trop Georg Med 1990; 42:52-57.
  • Gardner-Medwin JM, Dolezalova P, Cummins C, Southwood TR. Incidence of Henoch Schönlein purpura, Kawasaki disease and rare vasculitides in children of different ethnic origins. Lancet 2002; 360:1197-1202.
  • Dolezalova P, Telekesova P, Nemcova D, Hoza J. Incidence of vasculitis in children in the Czech republic: 2-year prospective epidemiology survey. J Rheumatol 2004; 31:2295-2299.
  • Garcia-Porrua C, Calvino MC, Llorca J, Couselo JM, Gonzalez Gay MA. Henoch Schönlein purpura in children and adults: clinical differences in a defined population. Semin Arthritis Rheum 2002; 32:149-156.
  • Trapani S, Micheli A, Grisolia F, et al. Henoch Schönlein purpura in childhood: epidemiological and clinical analysis of 150 cases over a 5-year period and review of literature. Semin Arthritis Rheum 2005; 35:143-153.
  • Robson WL, Leung AK. Henoch Schönlein purpura. Adv Pediatr 1994; 41:163-194.
  • Erdag GC, Vitrinel A, Yeşiltepe G, Gürsu DA, Ağzıkuru T, Akın Y. Henoch Schönlein Purpuralı 101 olgunun retrospektif değerlendirilmesi. Bakırköy Tıp Dergisi 2007; 3:10-14.
  • Cull DL, Rosario V, Lally KP, Ratner I, Mahour GH. Surgical implications of Henoch.Schönlein purpura. J Pediatr Surg 1990;25:741-743.
  • Martinez-Frontanilla LA, Silverman L, Meagher DP. Intussusception in Henoch.Schönlein purpura: diagnosis with ultrasound. J Pediatr Surg 1988; 23:375-376.
  • Stewart M, Savage JM, Bell B, McCord B. Long term renal prognosis of Henoch.Schönlein purpura in an unselected childhood population. Eur J Pediatr 1988; 147:113-115.
  • Mollica F, Li Volti S, Garozzo R, Russo G. Effectiveness of early prednisone treatment in preventing the development of nephropathy in anaphylactoid purpura. Eur J Pediatr 1992; 151:140-144.
  • Scharer K, Krmar R, Querfeld U, Ruder H, Waldherr R, Schaefer F. Clinical outcome of Schönlein.Henoch purpura nephritis in children. Pediatr Nephrol 1999; 13:816-823.
  • Kaku Y, Nohara K, Honda S. Renal involment in HenochSchönlein purpura: A multivariate anlysis of prognostic factors. Kidney Int 1998; 53: 1755-1759.
  • Mills JA, Michel BA, Bloch DA, Calabrese LH, Hunder GG, Arend WP. The American College of Rheumatology 1990 criteria for the classification of Henoch Schönlein purpura. Arthritis Rheum 1990; 33:1114-1121.
  • Coppo R, Amore A. Henoch-Schönlein Purpura. In: Avner ED, Harmon WE, Niaudet P, editors. Pediatric Nephrology, fifth edition. Lippincott Williams-Wilkins. Philadelphia. 2004, p.851-863.

Çocuklarda Henoch-Schönlein Purpurası: 50 Olgunun Retrospektif Değerlendirilmesi

Year 2010, Volume: 15 Issue: 1, 27 - 30, 01.02.2010

Abstract

Amaç: Henoch-Schönlein purpurası başlıca çocukları etkileyen sistemik bir vaskülittir. Çalışmada Henoch-Schönlein purpurası tansı ile izlenen çocukları epidemiyolojik ve klinik özelliklerini değerlendirmeyi amaçladık. Gereç ve Yöntemler: Henoch-Schönlein purpurası tanısı alan tüm çocukların epidemiyolojik, klinik, laboratuar bulguları ve tedavi bilgileri dosya kayıtları incelenerek elde edildi. Bulgular: Yaşları 1.5 ile 16.5 arasında değişen 50 çocuk çalışmaya dahil edildi. Hastaların ortalama yaşları 7.9±3.6 yıl idi. Hastalarda en sık görülen bulgu purpura idi. Eklem tutulumu ve gastrointestinal tutulum hastalarda % 92 ve % 62 olarak belirlendi. Renal tutulum hastaların 10'nunda (% 20) meydana geldi. Bunların birinde şiddetli böbrek tutulumu oluştu. En sık görülen laboratuar anormalikleri lökositoz (%78), eritrosit sedimantasyon yüksekliği (% 48) ve IgA (% 26) yüksekliği idi. Sonuç: Hastaların epidemiyolojik ve klinik bulguları literatürdekilerle benzerlik gösteriyordu. Şiddetli böbrek tutulumu çocukların küçük bir kısmında olmasına rağmen, prognozu genellikle iyidir.

References

  • Cassidy JT, Petty RE. Leukocytoclastic vasculitis. In: Cassidy JT, Petty RE, editors. Textbook of pediatric Rheumatology. 5th ed. W.B. Saunders Co. Philadelphia. 2005, p.496-501.
  • Peru H, Soylemezoglu O, Bakkaloglu SA, et al. Henoch Schonlein purpura in chilhood: clinical analysis of 254 cases over a 3-year period. Clin Rheumatol 2008; 27: 1087-1092.
  • Lahita RG. Influence of age on Henoch Schönlein purpura. Lancet 1997; 350:1116-1117.
  • Szer IS. Henoch- Schönlein purpura: when and how to treat? J Rheumatol 1996; 23:1661-1665.
  • Ronkainen J, Nuutinen M, Koskimies O. The adult kidney 24 years after childhood Henoch.Schönlein purpura: a retrospective cohort study. Lancet 2002; 360:666-700.
  • Ronkainen J, Ala-Houhala M, Huttunen NP, et al. Outcome of Henoch.Schönlein nephritis with nephrotic-range proteinuria. Clin Nephrol 2003; 60:80-84.
  • Goldstein AR, White RH, Akuse R, Chantler C. Long term followup of childhood Henoch.Schönlein nephritis. Lancet 1992; 339:280-282.
  • Ozen S, Ruperto N, Dillon MJ, et al. EULAR/PReS Endorsed consensus criteria for the classification of childhood vasculites. Ann Rheum Dis 2006; 65: 936-941.
  • Tizard EJ. Henoch-Schönlein purpura. Arch Dis Child 1999; 89: 380-383.
  • Inal A, Yılmaz M, Kendirli SG, et al. Henoch-Schönlein purpurası tanısı olan çocukların klinik özellikleri. Erciyes Tıp Dergisi 2009; 31: 153-161.
  • Saulsbury FT. Henoch Schönlein purpura in children: report of 100 patients and review of the literature. Medicine 1999; 78:395-409.
  • Sano H, Izumida M, Shimizu H, Ogawa Y. Risk factors on renal involvement and significant proteinuria in Henoch Schönlein purpura. Eur J Pediatr 2002; 161:196-201.
  • Calvino MC, Llorca J, Garcia-Porrua C, et al. Henoch Schönlein purpura in children from northwestern Spain: a 20year epidemiologic and clinical study. Medicine 2001; 80:279-290.
  • Abdel-Al YK, Hejazi Z, Majeed HA. Henoch Schönlein purpura in Arab children. Analysis of 52 cases. Trop Georg Med 1990; 42:52-57.
  • Gardner-Medwin JM, Dolezalova P, Cummins C, Southwood TR. Incidence of Henoch Schönlein purpura, Kawasaki disease and rare vasculitides in children of different ethnic origins. Lancet 2002; 360:1197-1202.
  • Dolezalova P, Telekesova P, Nemcova D, Hoza J. Incidence of vasculitis in children in the Czech republic: 2-year prospective epidemiology survey. J Rheumatol 2004; 31:2295-2299.
  • Garcia-Porrua C, Calvino MC, Llorca J, Couselo JM, Gonzalez Gay MA. Henoch Schönlein purpura in children and adults: clinical differences in a defined population. Semin Arthritis Rheum 2002; 32:149-156.
  • Trapani S, Micheli A, Grisolia F, et al. Henoch Schönlein purpura in childhood: epidemiological and clinical analysis of 150 cases over a 5-year period and review of literature. Semin Arthritis Rheum 2005; 35:143-153.
  • Robson WL, Leung AK. Henoch Schönlein purpura. Adv Pediatr 1994; 41:163-194.
  • Erdag GC, Vitrinel A, Yeşiltepe G, Gürsu DA, Ağzıkuru T, Akın Y. Henoch Schönlein Purpuralı 101 olgunun retrospektif değerlendirilmesi. Bakırköy Tıp Dergisi 2007; 3:10-14.
  • Cull DL, Rosario V, Lally KP, Ratner I, Mahour GH. Surgical implications of Henoch.Schönlein purpura. J Pediatr Surg 1990;25:741-743.
  • Martinez-Frontanilla LA, Silverman L, Meagher DP. Intussusception in Henoch.Schönlein purpura: diagnosis with ultrasound. J Pediatr Surg 1988; 23:375-376.
  • Stewart M, Savage JM, Bell B, McCord B. Long term renal prognosis of Henoch.Schönlein purpura in an unselected childhood population. Eur J Pediatr 1988; 147:113-115.
  • Mollica F, Li Volti S, Garozzo R, Russo G. Effectiveness of early prednisone treatment in preventing the development of nephropathy in anaphylactoid purpura. Eur J Pediatr 1992; 151:140-144.
  • Scharer K, Krmar R, Querfeld U, Ruder H, Waldherr R, Schaefer F. Clinical outcome of Schönlein.Henoch purpura nephritis in children. Pediatr Nephrol 1999; 13:816-823.
  • Kaku Y, Nohara K, Honda S. Renal involment in HenochSchönlein purpura: A multivariate anlysis of prognostic factors. Kidney Int 1998; 53: 1755-1759.
  • Mills JA, Michel BA, Bloch DA, Calabrese LH, Hunder GG, Arend WP. The American College of Rheumatology 1990 criteria for the classification of Henoch Schönlein purpura. Arthritis Rheum 1990; 33:1114-1121.
  • Coppo R, Amore A. Henoch-Schönlein Purpura. In: Avner ED, Harmon WE, Niaudet P, editors. Pediatric Nephrology, fifth edition. Lippincott Williams-Wilkins. Philadelphia. 2004, p.851-863.
There are 28 citations in total.

Details

Primary Language Turkish
Journal Section Articles
Authors

Metin Kaya Gürgöze This is me

Mehmet Gündüzalp This is me

Publication Date February 1, 2010
Published in Issue Year 2010 Volume: 15 Issue: 1

Cite

APA Gürgöze, M. K., & Gündüzalp, M. (2010). Çocuklarda Henoch-Schönlein Purpurası: 50 Olgunun Retrospektif Değerlendirilmesi. Fırat Tıp Dergisi, 15(1), 27-30.
AMA Gürgöze MK, Gündüzalp M. Çocuklarda Henoch-Schönlein Purpurası: 50 Olgunun Retrospektif Değerlendirilmesi. Fırat Tıp Dergisi. February 2010;15(1):27-30.
Chicago Gürgöze, Metin Kaya, and Mehmet Gündüzalp. “Çocuklarda Henoch-Schönlein Purpurası: 50 Olgunun Retrospektif Değerlendirilmesi”. Fırat Tıp Dergisi 15, no. 1 (February 2010): 27-30.
EndNote Gürgöze MK, Gündüzalp M (February 1, 2010) Çocuklarda Henoch-Schönlein Purpurası: 50 Olgunun Retrospektif Değerlendirilmesi. Fırat Tıp Dergisi 15 1 27–30.
IEEE M. K. Gürgöze and M. Gündüzalp, “Çocuklarda Henoch-Schönlein Purpurası: 50 Olgunun Retrospektif Değerlendirilmesi”, Fırat Tıp Dergisi, vol. 15, no. 1, pp. 27–30, 2010.
ISNAD Gürgöze, Metin Kaya - Gündüzalp, Mehmet. “Çocuklarda Henoch-Schönlein Purpurası: 50 Olgunun Retrospektif Değerlendirilmesi”. Fırat Tıp Dergisi 15/1 (February 2010), 27-30.
JAMA Gürgöze MK, Gündüzalp M. Çocuklarda Henoch-Schönlein Purpurası: 50 Olgunun Retrospektif Değerlendirilmesi. Fırat Tıp Dergisi. 2010;15:27–30.
MLA Gürgöze, Metin Kaya and Mehmet Gündüzalp. “Çocuklarda Henoch-Schönlein Purpurası: 50 Olgunun Retrospektif Değerlendirilmesi”. Fırat Tıp Dergisi, vol. 15, no. 1, 2010, pp. 27-30.
Vancouver Gürgöze MK, Gündüzalp M. Çocuklarda Henoch-Schönlein Purpurası: 50 Olgunun Retrospektif Değerlendirilmesi. Fırat Tıp Dergisi. 2010;15(1):27-30.