ÇOCUK HASTALARDA HENOCH SCHÖNLEIN PURPURASINDA BAŞLANGIÇ KLİNİK BULGULARI İLE BÖBREK TUTULUMU ARASINDAKİ İLİŞKİ

Year 2023, Volume: 24 Issue: 4, 452 - 456, 09.10.2023

Dilek Çavuşoğlu , Ülkü Yıldırımer , Muhammet Ali Kanık , Mehmet Helvaci , Ali Rahmi Bakiler , Onder Yavascan

https://doi.org/10.18229/kocatepetip.1180611

Abstract

AMAÇ: Henoch-Schönlein purpurası (HSP) non-trombositopenik palpabıl purpura, karın ağrısı ve artritten oluşan üç önemli klinik bulgu ile karakterize IgA ilişkili sistemik bir vaskülittir. Böbrek tutulumu genellikle prognozu belirlemektedir. Bu çalışmada HSP tanısı ile izlenen çocukların klinik özelliklerini; cilt, gastrointestinal sistem (GİS), eklem ve böbrek tutulumunun şiddeti arasındaki ilişkinin belirlenmesi amaçlandı.
GEREÇ VE YÖNTEM: İleriye yönelik kesitsel olarak düzenlenen bu çalışmaya Ocak 2011 - Ocak 2012 tarihleri arasında izlenen 74 çocuk hasta öykü, fizik muayene, laboratuvar ölçümleri, izlemde aldıkları tedavi ve tedaviye alınan cevapla değerlendirildi. Hastaların sistem tutulumları deri, böbrek, GİS ve eklem tutulumu olarak sınıflandırıldı.
BULGULAR: Olguların %45,9’u kız, %54,1’i erkek olarak saptandı. İlk bir ayda artrit şiddeti ve böbrek tutulumu arasında anlamlı bir ilişki bulundu (p<0,05). Başvuru anında karın ağrısı şiddeti ile böbrek tutulumu arasında ve ayrıca altıncı ayda karın ağrısı şiddeti ve böbrek tutulumu şiddeti arasında anlamlı bir korelasyon saptandı (p<0,05). İlk bir ayda karın ağrısının ağrı kesiciye yanıtı ile böbrek tutulumu arasında anlamlı bir ilişki bulundu (p<0,05).
SONUÇ: Hastalığın başlangıcında ağır eklem ve GİS tutulumu ile başlangıçta GİS tutulumunun ağır olması 1. ve 6. ayda ağır böbrek tutulumu ile ilişkili bulundu. Başlangıçta şiddetli karın ağrısı olan bu nedenle hiç hareket edemeyen, oyundan geri kalan, sürekli yatmayı tercih eden olan ve/veya melena saptanan olgular böbrek tutulumu açısından daha dikkatli değerlendirilmelidir

Keywords

Vaskülit, Böbrek, Çocuk.

THE RELATIONSHIP BETWEEN INITIAL CLINICAL FINDINGS AND RENAL INVOLVEMENT OF HENOCH SCHÖNLEIN PURPURA IN PEDIATRIC PATIENTS

Abstract

OBJECTIVE: Henoch-Schönlein purpura (HSP) is an IgA-associated systemic vasculitis characterized by three important clinical signs of non-thrombocytopenic palpable purpura, abdominal pain, and arthritis. Renal involvement generally determines the prognosis. In this study, it was aimed to determine the relationship between skin, gastrointestinal system (GIS), the severity of joint and renal involvement on the clinical features of children who were followed up with the diagnosis of HSP.
MATERIAL AND METHODS: In this prospective cross-sectional study, 74 pediatric patients followed up between January 2011 and January 2012 were evaluated with their history, physical examination, laboratory measurements, treatment received during follow-up, and response to treatment. System involvement of the patients was classified as skin, renal, GIS, and joint involvement.
RESULTS: It was determined that 45.9% of the cases were female and 54.1% were male. A significant correlation was found between the severity of arthritis and renal involvement in the first month (p<0.05). There was a significant correlation between the severity of abdominal pain and renal involvement at the time of admission, and also the severity of abdominal pain and severity of renal involvement at the sixth month (p<0.05). A significant correlation was found between the response of abdominal pain to painkillers and renal involvement in the first month (p<0.05).
CONCLUSIONS: Severe joint and GIS involvement at the beginning of the disease and severe GIS involvement at the beginning were found to be associated with severe renal involvement in the first and sixth months. Patients who initially had severe abdominal pain, and therefore could not move at all, fall behind from the game, prefer to lie down continuously, and/or those with melena should be evaluated more carefully in terms of renal involvement.

Keywords

Vasculitis, Kidney, Child.

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