Henoch Schönlein purpura in children: retrospective analysis of 46 cases and review of literature

Yıl 2015, Cilt: 5 Sayı: 1, 20 - 25, 07.09.2015

Sevil Bilir Göksügür Mervan Bekdaş Betül Şereflican Nadir Göksügür Mustafa Erkoçoğlu

https://doi.org/10.5505/sakaryamj.2015.27879

Öz

AimTo evaluate clinical and laboratory characteristics of Henoch Schönlein's purpura (HSP) patients, review of the literature about the risc factors affecting prognosis.Material and methodsMedical records of patients with HSP diagnosis following in Abant Izzet Baysal University, Department of Pediatrics with diagnosis HSP were evaluated retrospectively.ResultsThe patient population consisted of 46 children (25 boys, 21 girls, mean age: 6.4 years; range: 3-15 years). Petechiae - purpura was present in 46 (100 %) cases, arthritis/arthralgias in 25 (54.3%), abdominal involvement in 27 (58.6 %), and renal involvement in 15 (32.6 %). ConclusionHSPN is a mostly mild and self-limited desease but rarely may lead to chronic kidney disease. The long-term morbidity of Henoch–Schönlein purpura is related to renal involvement. Every child with HSP should have urinalysis periodically performed at diagnosis and during following one year.

Anahtar Kelimeler

Henoch Schönlein purpura, nephritis, purpura, vasculitis

Çocuklarda Henoch Schönlein purpurası: 46 olgunun geriye dönük analizi ve literatürün incelenmesi

Öz

AmaçHenoch Schönlein purpurası (HSP) tanılı hastaların klinik ve laboratuvar karakteristiklerinin değerlendirilmesi, prognozu etkileyen risk faktörlerinin literatür eşliğinde incelenmesi.Gereç ve yöntemAbant İzzet Baysal Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim Dalı'nda izlenen HSP tanılı hastaların tıbbi kayıtları geriye dönük olarak incelendi. Bulgular Hasta popülasyonu 46 çocuktan oluşmaktadır (25 erkek, 21 kız, ortalama yaş: 6,4, yaş aralığı: 3-15). Peteşi- purpura 46 hastada (% 100), artrit- artralji 25 hastada (% 54,3), gastrointestinal sistem tutulumu 27 hastada (% 58,6), renal tutulum 15 hastada (% 32,6) gözlendi.SonuçHSP genelde hafif seyirli ve kendini sınırlayan bir hastalık olup nadiren kronik böbrek yetmezliğine yol açabilir. HSP'nın uzun dönem morbiditesi renal tutulumla ilişkilidir. HSP'lı her çocuk tanıdan itibaren 1 yıl boyunca periodik olarak tam idrar analizi yaptırmalıdır.

Anahtar Kelimeler

Henoch Schönlein purpurası, nefrit, purpura, vaskülit

Kaynakça

• Gardner-Medwin JM, Dolezalova P, Cummins C, Southwood TR. Incidence of Henoch-Schonlein purpura, Kawasaki disease, and rare vasculitides in children of different ethnic origins. Lancet 2002; 360: 1197-202.
• Saulsbury FT. Henoch-Schonlein purpura in children. Report of 100 patients and review of the literature. Medicine (Baltimore) 1999; 78: 395-409.
• Pohl M. Henoch-Schonlein purpura nephritis. Pediatr Nephrol 2014.
• Ozen S, Pistorio A, Iusan SM, Bakkaloglu A, Herlin T, Brik R et al. EULAR/PRINTO/PRES criteria for Henoch-Schonlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis 2010; 69: 798-806.
• Anil M, Aksu N, Kara OD, Bal A, Anil AB, Yavascan O et al. Henoch-Schonlein purpura in children from western Turkey: a retrospective analysis of 430 cases. Turk J Pediatr 2009; 51: 429-36.
• Calvo-Rio V, Loricera J, Mata C, Martin L, Ortiz-Sanjuan F, Alvarez L et al. Henoch-Schonlein purpura in northern Spain: clinical spectrum of the disease in 417 patients from a single center. Medicine (Baltimore) 2014; 93: 106-13.
• 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: 94-9.
• Donmez O, Yıldırım NS, Durmaz O. Henoch Schnlein Purpuralı Değerlendirilmesi. J Curr Ped 2011; 9: 63-67. Yıllık Retrospektif
• Ece A Yİ, Balık H, Kocamaz H, Yel S, Uluca Ü, Tan İ. Çocuklarda Henoch-Schönlein purpurası: 214 hastanın değerlendirilmesi. J Clin Exp Invest 2012; 3: 91-5.
• Ersen A, Aydınoz S, Karademir F. Çocukluk dönemi Henoch- Schönlein purpurası: 42 Olgunun retrospektif analizi. Dirim 2009; 84: 35-41.
• Lardhi AA. Henoch-Schonlein purpura in children from the eastern province of Saudi Arabia. Saudi Med J 2012; 33: 973-8.
• Mao Y, Yin L, Huang H, Zhou Z, Chen T, Zhou W. Henoch- Schonlein purpura in 535 Chinese children: clinical features and risk factors for renal involvement. J Int Med Res 2014; 42: 1043-9.
• Tabel Y, Çetin M. Çocuklarda Henoch-Schönlein purpurası, gastrointestinal sistem tutulumu ve tedavisi. Adnan Menderes Üniversitesi Tıp Fakültesi Dergisi 2008; 9: 17-20.
• 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: 269-74.
• Davin JC, Coppo R. Henoch-Schonlein purpura nephritis in children. Nat Rev Nephrol 2014; 10: 563-73.
• Trnka P. Henoch-Schonlein purpura in children. J Paediatr Child Health 2013; 49: 995-1003.
• Rigante D, Candelli M, Federico G, Bartolozzi F, Porri MG, Stabile A. Predictive factors of renal involvement or relapsing disease in children with Henoch-Schonlein purpura. Rheumatol Int 2005; 25: 45-8.
• Sano H, Izumida M, Shimizu H, Ogawa Y. Risk factors of renal involvement and significant proteinuria in Henoch- Schonlein purpura. Eur J Pediatr 2002; 161: 196-201.
• Shin JI, Park JM, Shin YH, Hwang DH, Kim JH, Lee JS. Predictive factors for nephritis, relapse, and significant proteinuria in childhood Henoch-Schonlein purpura. Scand J Rheumatol 2006; 35: 56-60.
• Narchi H. Risk of long term renal impairment and duration of follow up recommended for Henoch-Schonlein purpura with normal or minimal urinary findings: a systematic review. Arch Dis Child 2005; 90: 916-20.
• Camacho C, Leva EG. A rare presentation of seizures in a not-so-rare disease: Henoch-Schonlein purpura presenting with repeated seizures. Pediatr Emerg Care 2014; 30: 424- 6.
• Fatima A, Gibson DP. Pneumatosis intestinalis associated with Henoch-Schonlein purpura. Pediatrics 2014; 134: e880-3.
• Hernandez Roca JJ, Pelaez Ballesta A, Lara G, Soto S, Mene Fenor E. Diffuse alveolar hemorrhage associated with Henoch-Schonlein purpura and Pneumocystis jirovecii infection: A case report. Rev Clin Esp 2014.
• Hogendorf A, Mlynarski W. Factor XIII deficiency in Henoch- Schonlein purpura - report on two cases and literature review. Dev Period Med 2014; 18: 318-22.
• Kanik A, Kose E, Baran M, Sirin Kose S, Eliacik K, Sayan A et al. Henoch-Schonlein Purpura in Two Pediatric Patients Presenting as Terminal Ileitis. Dig Dis Sci 2014.
• Semeena N, Adlekha S. Henoch-schonlein purpura associated with gangrenous appendicitis: a case report. Malays J Med Sci 2014; 21: 71-3.
• Teng X, Wang Y, Lin N, Sun M, Wu J. Evaluation of serum procalcitonin and C-reactive protein levels as biomarkers of Henoch-Schonlein purpura in pediatric patients. Clin Rheumatol 2014.
• Cao N, Chen T, Guo ZP, Li MM, Jiao XY. Elevated serum levels of visfatin in patients with henoch-schonlein purpura. Ann Dermatol 2014; 26: 303-7.
• Chen T, Lu YH, Wang WJ, Bian CY, Cheng XY, Su Y et al. Elevated urinary levels of cystatin C and neutrophil gelatinase-associated lipocalin in Henoch-Schonlein purpura patients with renal involvement. PLoS One 2014; 9: e101026.
• Makay B, Gucenmez OA, Duman M, Unsal E. The relationship of neutrophil-to-lymphocyte ratio with gastrointestinal bleeding in Henoch-Schonlein purpura. Rheumatol Int 2014; 34: 1323-7.
• Cai HB, Li YB, Zhao H, Zhou SM, Zhao XD. [Prognostic analysis of children with Henoch-Schonlein purpura treated by Helicobacter pylori eradication therapy]. Zhongguo Dang Dai Er Ke Za Zhi 2014; 16: 234-7.
• Chartapisak W, Opastirakul S, Hodson EM, Willis NS, Craig JC. Interventions for preventing and treating kidney disease in Henoch-Schonlein Purpura (HSP). Cochrane Database Syst Rev 2009: Cd005128.
• Tudorache E, Azema C, Hogan J, Wannous H, Aoun B, Decramer S et al. Even mild cases of paediatric Henoch- Schonlein purpura nephritis show significant long-term proteinuria. Acta Paediatr 2014.
• Nikibakhsh AA, Mahmoodzadeh H, Karamyyar M, Hejazi S, Noroozi M, Macooie AA. Treatment of severe henoch- schonlein purpura nephritis with mycophenolate mofetil. Saudi J Kidney Dis Transpl 2014; 25: 858-63.
• Pindi Sala T, Michot JM. Successful outcome of a corticodependent henoch-schonlein purpura adult with rituximab. 2014; 2014: 619218.