Evaluation of Follow-up Results in Children with Henoch-Schönlein Purpura

Yıl 2016, Cilt: 7 Sayı: 4, 269 - 277, 01.12.2016

Dursun Eryılmaz Aydın Ece

https://doi.org/10.5799/jcei.328558

Öz

Objective: The aim of this study was to investigate long-term follow-up results of children Henoch-Schönlein purpura
(HSP).
Methods: 102 children (66 boys and 36 girls) with HSP followed up at Pediatric Department of Dicle University
Faculty of Medicine between 1996 and 2002 were included. Demographic, clinical and laboratory characteristics of
children, treatment modalities and complications were reviewed from the follow-up charts of patients. Fourty-eigth
children who came to control after a period of 40.8±19.9 months underwent a thorough clinical and laboratory work
up. Clinical and laboratory findings accompanying specific organ involvements were investigated.
Results: In total, 91.2% had purpuric eruption, 62.7% had gastrointestinal system (GIS) involvement, 28.4% had
renal involvement and 43.1% had arthritis. Triggering factors were upper respiratory tract infection in 55%,
vaccination in 2 and drugs in 2 patients. Gastrointestinal involvement was significantly more frequent in children with
high immunglobulin A levels (p=0.012), renal involvement was significantly more frequent in children with high
erythrocyte sedimentation rate (p=0.006). GIS involvement was more frequent in patients over 7 years (p<0.05).
Significant correlations were found between renal involvement and leukocytosis, thrombocytosis and high C-reactive
(41.2%) with skin eruptions and in 33 (32.4%) with abdominal discomfort. Symptoms and signs were relapsed two
times in 12 patients and three times in 13. The existence of hypertension, older age, low C3 levels were found to be
associated with renal involvement in logistic regression analysis (p<0.05).
Conclusion: Increased IgA level and age over 7 were associated with GIS involvement, while high acute phase
reactants and older age were found to be related with renal involvement. J Clin Exp Invest 2016; 7(4): 269-277. 

Anahtar Kelimeler

Henoch-Schönlein Purpura, children, clinical findings, laboratory findings, follow up results

Kaynakça

• 1. Chen JY, Mao JH. Henoch-Schönlein purpura nephritis in children: incidence, pathogenesis and management. World J Pediatr 2015; 11:29-34.
• 2. Lanzkowsky S, Lanzkowsky L, Lanzkowsky P. Henoch-Schönlein Purpura. Pediatr Rev 1992; 13: 130-137.
• 3. Sharief N, Ward HC, Wood CBS. Functional intestinal obstruction in Henoch-Schönlein purpura. J Pediatr Gastroenterol Nutr 1991;12:272-275.
• 4. Katz S, Borst M, Seekri I, Grosfeld JL. Surgical evaluation of Henoch-Schönlein purpura. Experience with 110 children. Arch Surg 1991;126:849-853.
• 5. Storm K, Ostergaard JR. Infection as the precipitating factor in Schönlein-Henoch purpura. (abstract) Ugeskr Laeger 1991;153:192-195.
• 6. Ece A, Gürkan F, Haspolat K, Katar S. HenochSchönlein purpuralı çocuklarda renal ve gastrointestinal tutulumla ilişkili klinik ve laboratuar bulgular. Çocuk Sağlığı ve Hastalıkları Dergisi 2000; 43:36-42.
• 7. Kaku Y, Nohara K, Honda S. Renal involvement in Henoch-Schönlein purpura: a multivariate analysis of prognostic factors. Kidney Int 1998;53:1755-1759.
• 8. Beşbaş N, Özaltın F. Sistemik vaskülit. Katkı Pediatri Dergisi. 1999;20:703-725.
• 9. Stewart M, Savage JM, Bell B, Mccord B.Long term renal prognosis of Henoch-Schönlein purpura in an unselected childhood population Eur J Pediatr 1998;147:113-115.
• 10. Mollica F, Li Volti S, Garozzo R, Russo G. Effectiveness of early prednisone treatment in preventing the development of nephropaty in anaphylactoid purpura. Eur J Pediatr 1992;151:140-144.
• 11. Bona G, Monti G. Henoch-Scöhlein syndrome in children. Clinico-epidemiologic analysis of 170 cases. Minerva Pediatr 1989; 41: 587- 592.
• 12. Saulsbury FT, Kesler RW. Trombocytosis in Henoch-Schönlein purpura Clin Pediatr 1983;22:185-187. 13. Laor T, Atala A, Teele RL. Scrotal ultrasonography in Henoch-Schönlein purpura. Pediatr Radiol 1992;22:505-506.
• 14. Van EsLA, Kauffmann RH, Valentijn RM. Renal manifestation of systemic disease: Henoch-Schönlein purpura. In: Holiday MA, Barratt TM Vernier RL (ed). Pediatric Nephrology (2nd ed). Baltimore: Williams and Wilkins, 1987: 492-498.