Abstract
BackgroundAlthough joint involvement is the second most common clinical manifestation after skin involvement in patients with Henoch-Schönlein purpura (HSP), it has not been well characterized. The aim of this study was to profile the clinical characteristics and identify the potential risk factors for kidney damage in HSP patients having joint involvement.MethodsWe retrospectively reviewed 71 cases of HSP patients with joint involvement who attended our hospital between January 2010 and March 2012 and analyzed their epidemiological profile, clinical characteristics, follow-up findings (up to three years) and overall prognosis. Logistic regression analysis was performed to identify risk factors associated with renal symptoms in HSP patients with joint involvement.ResultsAverage age of patients was 8.55 ± 2.13 years with male to female ratio at 1.29:1. The peak age of disease onset was six to 11 years. The most common triggers included upper respiratory infection, vigorous physical activity, and autumn and winter seasons. Forty cases (56.35 %) had gastrointestinal involvement and 37 (52.11 %) had kidney damage; gastrointestinal system, scrotal involvement, and increased D-dimer levels were significantly associated with kidney injury (P < 0.05) by multivariate analysis. Glucocorticoid therapy was effective in alleviating symptoms.ConclusionGastrointestinal symptoms, scrotal involvement, and increased D-dimer are the potential risk factors for kidney damage in HSP patients having joint involvement. Rational use of corticosteroids was probably responsible for the good clinical outcomes.
Highlights
Joint involvement is the second most common clinical manifestation after skin involvement in patients with Henoch-Schönlein purpura (HSP), it has not been well characterized
Respiratory tract infection was the most frequent predisposing factor followed by vigorous exercise, with 66 cases (93 %) being aware of the trigger factors (Fig. 3)
To summarize, HSP with joint involvement most commonly occurred in school-aged males during fall and winter seasons
Summary
Joint involvement is the second most common clinical manifestation after skin involvement in patients with Henoch-Schönlein purpura (HSP), it has not been well characterized. Henoch-Schönlein purpura (HSP) is the most common form of vasculitis in children. The estimated annual incidence of HSP in China is 14.06 cases per 100,000 children [1] with an increasing trend observed over successive years, this rising trend has recently tapered, possibly due to changes in social, economic, health, and environmental conditions [2]. Factors triggering HSP include infections (mainly upper respiratory infection), drugs, food, insect bites and vaccination. Physical conditions, such as exposure to cold are known to be environmental triggers for the disease onset. The pathogenesis of HSP is related to aberrant deposition of IgA-containing
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