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

Abstract

Objective: The aim of this study was to investigate long-term follow-up results of children Henoch-Schonlein 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 protein levels (p<0.05). Mean healing period of the disease was 17.89.2 days. First relapses occurred in 42 patients (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.