Çocuklarda Henoch-Schönlein Purpurası: 2 Yıllık Tek Merkez Deneyimi

Yıl 2020, Cilt: 17 Sayı: 2, 201 - 206, 20.08.2020

Mehtap Akbalık Kara , Beltinge Demircioğlu Kılıç , M Buyukcelik , Ayşe Balat

https://doi.org/10.35440/hutfd.697466

Öz

Amaç: Henoch-Schönlein purpurası (HSP) tanısı ile izlenen hastaların demografik, klinik ve laboratuvar özelliklerini değerlendirmek ve böbrek tutulumu riski açısından karşılaştırmak
Materyal ve metod: Ocak 2015-Ocak 2017 tarihleri arasında hastanemiz çocuk nefroloji-romatoloji polikliniğinde HSP tanısı konup en az 1 yıl süre ile izlenen hastaların dosyaları gözden geçirildi. Demografik veriler, öykü, tanı yaşı, fizik muayene, laboratuvar tetkikleri, organ tutulumları, böbrek biyopsileri, tüm tedavi rejimleri ve izlemleri değerlendirildi.
Bulgular: Çalışmamızda 2 yıllık süre içinde 57’si erkek (% 48.3) 61’i kız (% 51.7) toplam 118 hasta vardı. Hastaların yaş ortalaması 7.9 ± 2.81, kız: erkek oranı 1: 0.93 idi. 10 yaş altında 98 hasta (% 83.1) varken, 10 yaş üzeri hasta sayısı 20 (% 16.9) idi. Hastalarda yaş, cinsiyet, hastalık tekrarı, eklem tutulumu yeri ve süresi, döküntünün yeri ve süresi, gastrointestinal tutulum, testis tutulumu, laboratuar parametreleri ile böbrek tutulumu karşılaştırıldığında anlamlı bir ilişki saptanmadı.
Sonuç: İki yıllık süre içinde HSP tanısı ile izlediğimiz hastaları geriye dönük olarak değerlendirdiğimizde böbrek tutulumu açısından risk faktörlerine baktığımızda anlamlı bir faktör tespit edemedik. Aslında bu durum bize tüm HSP hastalarının dikkatli bir biçimde renal tutulum açısından takip edilmesi gerektiğini düşündürmektedir.
Abstract
Background: To evaluate the demographic, clinical and laboratory characteristics of patients with Henoch-Schönlein purpura (HSP) and compare the risk of renal involvement
Materials and Methods: The files of the patients who were diagnosed as HSP in the pediatric nephrology-rheumatology clinic of our hospital between January 2015 and January 2017 and followed for at least 1 year were reviewed. Demographic data, history, age at diagnosis, physical examination, laboratory tests, organ involvement, renal biopsies, all treatment regimens and follow-up were evaluated.
Results: There were 118 patients 57 male (48.3%), 61 female (51.7%) in a 2-year period. The mean age of the patients was 7.9 ± 2.81 and the female: male ratio was 1: 0.93. While there were 98 patients (83.1%) under 10 years of age, the number of patients over 10 years of age was 20 (16.9%). There was no significant relationship between age, sex, recurrence of disease, location and duration of joint involvement, location and duration of rash, gastrointestinal involvement, testicular involvement, laboratory parameters and renal involvement.
Conclusion: When we retrospectively evaluated the patients whom were followed up with the diagnosis of HSP over a two-year period, we did not find any significant factor in the risk factors for renal involvement. In fact, this suggests that all HSP patients should be carefully monitored for renal involvement.

Anahtar Kelimeler

Çocukluk çağı, , Henoch-Schönlein purpurası

Destekleyen Kurum

yok

Henoch-Schönlein Purpura in children: 2 years of single center experience

Öz

Background: To evaluate the demographic, clinical and laboratory characteristics of patients with Henoch-Schönlein purpura (HSP) and compare the risk of renal involvement
Materials and Methods: The files of the patients who were diagnosed as HSP in the pediatric nephrology-rheumatology clinic of our hospital between January 2015 and January 2017 and followed for at least 1 year were reviewed. Demographic data, history, age at diagnosis, physical examination, laboratory tests, organ involvement, renal biopsies, all treatment regimens and follow-up were evaluated.
Results: There were 118 patients 57 male (48.3%), 61 female (51.7%) in a 2-year period. The mean age of the patients was 7.9 ± 2.81 and the female: male ratio was 1: 0.93. While there were 98 patients (83.1%) under 10 years of age, the number of patients over 10 years of age was 20 (16.9%). There was no significant relationship between age, sex, recurrence of disease, location and duration of joint involvement, location and duration of rash, gastrointestinal involvement, testicular involvement, laboratory parameters and renal involvement.
Conclusion: When we retrospectively evaluated the patients, who were followed up with the diagnosis of HSP over a two-year period, we did not find any significant factor in the risk factors for renal involvement. In fact, this suggests that all HSP patients should be carefully monitored for renal involvement.

Anahtar Kelimeler

Childhood, Henoch-Schönlein purpura.

Kaynakça

• 1. Wang X, Zhu Y, Gao L, Wei S, Zhen Y, Ma Q. Henoch-Schönlein purpura with joint involvement: Analysis of 71 cases. Pediatric Rheumatology. 2016;14(1):20. 2. Saulsbury FT. Henoch-Schönlein purpura. Curr Opin Rheumatol. 2001;13(1):35-40. 3. Chen J, Fang X, Dang X, Wu X, Yi Z. Association of the paired box 2 gene polymorphism with the susceptibility and pathogenesis of Henoch Schönlein purpura in children. Mol Med Rep. 2015;11(3): 1997-2003. 4. Zaffanello M, Brugnara M, Franchini M. Therapy for children with henoch-schonlein purpura nephritis: a systematic review. Scientific World Journal. 2007; 10(7): 20-30. 5. Jauhola O, Ronkainen J, Autio-Harmainen H, Koskimies O, Ala-Houhala M, Arikoski P, et al. Cyclosporine A vs. methylprednisolone for Henoch-Schönlein nephritis: a randomized trial. Pediatr Nephrol. 2011; 26(12): 2159-66. 6. Chen JY, Mao JH. Henoch-Schönlein purpura nephritis in children: incidence, pathogenesis and management.World J Pediatr. 2015;11(1):29-34. 7. Ozen S, Pistorio A, Iusan SM, Bakkaloglu A, Herlin T, Brik R, et al; Paediatric Rheumatology International Trials Organisation (PRINTO).EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis. 2010;69(5):798-806. 8. Lee YH, Kim YB, Koo JW, Chung JY. Henoch-Schonlein Purpura in Children Hospitalized at a Tertiary Hospital during 2004-2015 in Korea: Epidemiology and Clinical Management.Pediatr Gastroenterol Hepatol Nutr. 2016;19(3):175-185. 9. Counahan R, Winterborn MH, White RH, HeatonJM, Meadow SR, Bluett NH, et al. Prognosis of Henoch-Schönlein nephritis in children. Br Med J.1977; 2:11-4. 10. Ozen S. The spectrum of vasculitis in children. Best Pract Res Clin Rheumatol. 2002; 16(3):411-25. 11. Calviño MC, Llorca J, García-Porrúa C, Fernández-Iglesias JL, Rodriguez-Ledo P, González-Gay MA. Henoch-Schönlein purpura in children from northwestern Spain: A 20-year epidemiologic and clinical study. Medicine (Baltimore). 2001;80(5): 279-90. 12. Trapani S, Micheli A, Grisolia F, Resti M, Chiappini E, Falcini F, et al. Henoch Schonlein purpura in childhood: epidemiological and clinical analysis of 150 cases over a 5-year period and review of literature. Semin Arthritis Rheum. 2005;35(3):143-53. 13. Nong BR, Huang YF, Chuang CM, Liu CC, Hsieh KS. Fifteen-year experience of children with Henoch-Schönlein purpura in southern Taiwan, 1991-2005. J Microbiol Immunol Infect. 2007;40(4):371-6. 14. Rigante D, Candelli M, Federico G, Bartolozzi F, Porri MG, Stabile A. Predictive factors of renal involvement or relapsing disease in children with Henoch-Schönlein purpura.Rheumatol Int. 2005; 25(1): 45-8. 15. Chen O, Zhu XB, Ren P, Wang YB, Sun RP, Wei DE. Henoch Schonlein Purpura in children: clinical analysis of 120 cases. Afr Health Sci. 2013;13(1): 94-9. 16. Anil M, Aksu N, Kara OD, Bal A, Anil AB, Yavaşcan O, et al. Henoch-Schönlein purpura in children from western Turkey: a retrospective analysis of 430 cases.Turk J Pediatr. 2009;51(5): 429-36. 17. Demircioğlu Kiliç B, Kasap Demir B. Determination of Risk Factors in Children Diagnosed With Henoch-Schönlein Purpura. Arch Rheumatol. 2018; 33(4):395-401. 18. Zhao YL, Liu ZJ, Bai XM, Wang YC, Li GH, Yan XY. Obesity increases the risk of renal involvement in children with Henoch-Schönlein purpura.Eur J Pediatr. 2015;174(10):1357-63. 19. Chan H, Tang YL, Lv XH, Zhang GF, Wang M, Yang HP, et al. Risk Factors Associated with Renal Involvement in Childhood Henoch-Schönlein Purpura: A Meta-Analysis.PLoS One. 2016; 11(11): e0167346. 20. Lim Y, Yi BH, Lee HK, Hong HS, Lee MH, Choi SY, et al. Henoch-Schonlein purpura: ultrasonography of scrotal and penile involvement. Ultrasonography. 2015;34(2):144–147. 21. Tabel Y, Inanc FC, Dogan DG, Elmas AT. Clinical features of children with Henoch-Schonlein purpura: risk factors associated with renal involvement.Iran J Kidney Dis. 2012; 6(4):269-74. 22. Elmas AT, Tabel Y. Platelet Counts in Children With Henoch-Schonlein Purpura--Relationship to Renal Involvement. J Clin Lab Anal. 2016; 30(1):71-4. 23. Sano H, Izumida M, Shimizu H, Ogawa Y. Risk factors of renal involvement and significant proteinuria in Henoch-Schönlein purpura. Eur J Pediatr. 2002;161(4):196-201. 24. Amore A, Camilla R, Coppo R. News on the etiopathogenesis and the treatment of Schoenlein-Henoch nephritis. Minerva Pediatr. 2009;61(6):729-33. 25. Yin XL, Zou MS, Zhang Y, Wang J, Liu TL, Tang JH, et al. Twenty-three-year review of disease patterns from renal biopsies: an experience from a pediatric renal center. J Nephrol. 2013;26(4):699-707.