Predicting the Severity of Henoch–Schönlein Purpura: The Role of the Functional Platelet Indices

Abstract

Objecive: Our aim is to measure the discriminative competency of the qualitative platelet indices obtained at the time of diagnosis on the severity and outcome of Henoch-Schönlein purpura (HSP).

Materials and Methods: Electronic data of consecutive HSP children were extracted. The severity of the disease was estimated by an adopted clinical scoring system. Platelet count (PLT), mean platelet volume (MPV), plateletcrit (PCT), and platelet distribution width (PDW) indices at the time of diagnosis were recorded.

Results: Overall, 76 HSP patients (mean age: 7.4±2.5 years, 56.5% male) were evaluated. HSP was classified as mild in 59 (77.6%) cases and severe in 17 (22.4%). MPV was significantly lower in severe HSP patients (7.6±1 vs. 8.44±1.1, p<0.01), however, there was no significant difference for PCT and PDW parameters. Relapse occurred in 14 patients (18.4%, 5 mild HSP and 9 severe HSP patients) during follow up. Severe HSP cases were more prone to relapse (p<0.01) and relapsing HSP patients had lower PDW (13.2±3.1 vs. 14.8±2.4 p<0.05).

Conclusions: MPV level obtained at the time of first presentation of the HSP disease has a discriminative value for mild and severe HSP. Also, lower PDW might be predictive to suspect the HSP patients susceptive to relapse.

Keywords

• Children,Henoch-Schönlein purpura,mean platelet volume,platelet distribution width,plateletcrit

Henoch-Schönlein Purpurasının Ciddiyetini Öngörmek: Fonksiyonel Trombosit Belirteçlerinin Rolü

Öz

Amaç: Amacımız tanı anında saptanan kalitatif trombosit belirteçlerinin Henoch-Schönlein purpurası’ndaki (HSP) hastalık şiddeti ve gidişatının belirlenmesindeki yeterliliğinin değerlendirilmesidir.

Materyal ve Metot: HSP hastası çocukların elektronik verileri tarandı. Hastalığın ciddiyeti adapte edilmiş bir klinik skorlama sistemi ile belirlendi. Tanı anındaki trombosit sayısı, ortalama trombosit hacmi (MPV), plateletkrit (PCT) ve trombosit dağılım genişliği (PDW) belirteçleri kaydedildi.

Bulgular: Toplam 76 HSP hastası (ortalama yaş: 7,4±2,5 yıl, %56,5 erkek) değerlendirildi, 59 (%77,6) olguda HSP hafif ve 17 (%22,4) olguda ciddiydi. Ciddi HSP olgularında MPV belirgin olarak düşüktü (7,6±1,0 vs. 8,44±1,1, p<0,01), ancak PCT ve PDW belirteçlerinde anlamlı bir fark yoktu. Hastaların 14’ünde relaps izlendi (%18,4, 5 hafif HSP ve 9 ciddi HSP olgusu). Ciddi HSP olgularında relapsa yatkınlık daha fazlaydı (p<0,01) ve relaps olan hastalarda PDW daha düşüktü (13,2±3,1 vs. 14,8±2,4 p<0,05).

Sonuç: HSP olgularında tanı anında saptanan MPV düzeyleri hafif ve ciddi hastalığın ayrımında faydalıdır. Ayrıca, düşük PDW düzeyleri relapse yatkınlığı olan HSP hastalarının ön görülmesinde yararlı olabilir.

Anahtar Kelimeler

• Çocuk,Henoch-Schönlein purpura,ortalama trombosit hacmi,plateletkrit,trombosit dağılım genişliği

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