Henoch-Schonlein Purpura in childhood: a tertiary care hospital experience in Turkey

Authors

  • Aysegul Bukulmez Department of Pediatrics, Afyon Kocatepe University Medical Faculty, Afyonkarahisar, Turkey
  • Ecenur Dursun Department of Pediatrics, Afyon Kocatepe University Medical Faculty, Afyonkarahisar, Turkey
  • Ayse Tolunay Oflu Department of Pediatrics, Afyon Kocatepe University Medical Faculty, Afyonkarahisar, Turkey
  • Ayhan Pektas Department of Pediatrics, Afyon Kocatepe University Medical Faculty, Afyonkarahisar, Turkey
  • Tolga A. Sen Department of Pediatrics, Afyon Kocatepe University Medical Faculty, Afyonkarahisar, Turkey
  • Ahmet A. Tuncer Department of Pediatric Surgery, Afyon Kocatepe University Medical Faculty, Afyonkarahisar, Turkey
  • Kibriya Fidan Department of Pediatric Nephrology, Gazi University Medical Faculty, Ankara, Turkey

DOI:

https://doi.org/10.18203/2349-3291.ijcp20181026

Keywords:

Gastrointestinal tract, Henoch-Schönlein purpura, Renal involvement, Vasculitis

Abstract

Background: This study examines the clinical and laboratory features of children with Henoch-Schönlein purpura.

Methods: A retrospective study was applied for the 32 Henoch-Schönlein purpura patients who were monitored between January 2014 and June 2017 at the Pediatric clinic of a tertiary care hospital. The diagnoses were made based on the HSP criteria of the American College of Rheumatology. Age, gender, clinical and laboratory findings of the patients were recorded.

Results: The mean age of the 32 Henoch-Schönlein purpura patients was 9.29±3.29 years. Complaints at the time of admission were as follows: 93.8% of the patients (n=30) had rash; 40.6% (n=13) had abdominal pain; and 59.4% (n=19) had joint involvement and inability to walk. The results of fecal occult blood test examined during the admission were found as negative for the 75% (n=25) of patients and positive for the 19% (n=6) of patients. According to the urinary specimens, which were considered as the evidence of renal involvement at the applications, proteinuria was found negative for the 27 (8.4%) patients and positive for the 5 (1.6%) patients; hematuria was negative for the 29 (90.6%) children and positive for the 3 (%9.4) children. Antihistamine and non-steroidal anti-inflammatory were started as the treatment to the patients. During the follow-up, the 15.5% of patients had positive fecal blood tests although their test results were negative at the admission. During the clinical follow-up, the presence of proteinuria was found positive for the 6.3% of patients who had negative proteinuria test at their admissions.

Conclusions: Henoch-Schönlein purpura is a childhood vasculitis that manifests itself with rash and joint findings. It can cause significant complications due to gastrointestinal and genitourinary system involvement.

References

Miller ML, Pachman LM. Vasculitis syndromes:Henoch-Schönlein purpura. In: Behrman RE, Kliegman RB, Jensen HB, eds. Nelson Textbook of Pediatrics. 16th ed. Philadelphia: W.B. Saunders;2000:729.

Bagga A, Dillon MJ. Leukocytoclastic vasculitis. In: Cassidy JT, Petty RE, eds. Textbook of Pediatric Rheumatology. Philadelphia: W.B. Saunders;2001: 569-79.

Nielsen HE. Epidemiology of Schönlein Henoch purpura. Acta Pediatr Scand. 1988;77:125-31.

Mills JA, Michel BA, Bloch DA, Calabrese LH, Hunder GG, Arend WP, et al. The American College of Rheumatology 1990 criteria for the classification of Henoch-Schönlein purpura. Arthritis Rheum. 1990;33:1114-21.

Ozen S, Pistorio A, Iusan SM, Bakkaloglu A, Herlin T, Brik R, et al. Eular/Prınto/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;69:798-806.

Ozcakar O, Fitoz S, Yalçınkaya F. Henoch Schonlein purpura. Klinik Gelişim Dergisi. 2006;19:52-5.

Kawasaki Y, Suzuki J, Sakai N, Nemoto K, Nozawa R, Suzuki S, et al. Clinical and path-ological features of children with Henoch-Schoenlein purpura nephritis: risk factors associated with poor prognosis. Clin Nephrol. 2003;60:153-60.

Nuhoğlu Ç, Gedikoğlu H, Sonmez EO, Ozkozacı T, Ceran O. Retrospective analysis of demographic characteristics and laboratory findings of children with Henoch Schönlein purpura. Med J Haydarpaşa Numune Training Res Hospital. 2009;49:125-9.

Cakır M. Henoch-Schonlein purpura in North-Eastern Turkey. Ann Trop Paediatr. 2006;26:59-65.

Ersen A, Aydınoz S, Karademir F, Süleymanoğlu S, Meral C, Ozkaya H, et al. Henoch-Schonlein purpura of childhood: retrospective analysis of 42 cases. Dirim. 2009;84:35-41.

Garcia-Porrua C, Calvino MC, Llorca J, Couselo JM, Gonzalez Gay MA. Henoch-Schonlein purpura in children and adults: clinical differences in a defined population. Semin Arthritis Rheum. 2002;32:149-56.

Inal A, Yılmaz M, Kendirli SG, Altıntaş DU, Karakoç GB, Doğruel D. The clinical Characteristics of Children with Henoch Schönlein Purpura. Erciyes Med J. 2009;31:153-61.

Bagga A, Kabra SK, Srivastava RN, Bhuyan UN. Henoch-Schönlein syndrome in Northern Indian children. Indian Pediatr. 1991;28:1153-7.

Jeong YK, Ha HK, Yoon CH, Gong G, Kim PN, Lee MG, et al. Gastrointestinal involvement in Henoch-Schonlein syndrome: CT findings. Am J Roentgenol. 1997;168:965-8.

Rosenblum ND, Winter HS. Steroid effects on the course of abdominal pain in childhood with Henoch-Schönlein purpura. Pediatrics 1987;79:1018-21.

Koskimies O, Mir S, Rapola J, Viska J. Henoch- Schönlein nephritis: long term prognosis of unselected patients. Arch Dis Child. 1981;56:482-4.

Bayrakçı US, Topaloğlu R, Söylemezoğlu O, Kalyoncu M, Ozen S, Besbas N, et al. Effect of early corticosteroid therapy on development of Henoch-Schönlein nephritis. J Nephrol. 2007;20:406-9.

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Published

2018-04-20

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Original Research Articles