Henoch-Schönlein purpura in childhood: Review of 214 patients

Abstract

Objectives: Due to involvement of various systems and clinical variety of in Henoch-Schönlein purpura (HSP), in this study, it was aimed to investigate clinical and laboratory features of children with HSP. Materials and methods: Hospital records of 214 children with HSP followed up between 2000 and 2007 at Dicle University Hospital Pediatrics Clinics were retrospectively evaluated. Diagnosis was made based on the HSP criteria of American College of Rheumatology. Age, gender, clinical findings, laboratory variables, applied treatments, and outcome were recorded. Results: Totally 214 HSP patients (121 male, 93 female) with the mean age of 9.0 ± 3.2 years (range, 2-16) were included. There was a history of upper respiratory tract infection in 136 children (63.6%). There was abdominal pain in 62.1% of patients, vomiting in 22.1%, and occult blood in stool or melena in 25.4%. Three patients underwent operation due to intusception. Joint involvement was seen in 117 (54.7%) and angioedema in 73 (34.3%) of patients. Renal involvement as hematuria was seen in 63 (29.4%) children, proteinuria in 57 (26.6%), leukocyturia (9.8%), and nephritic/nephritic proteinuria in five patients. Increased IgA and C3 levels were found in 35 (16.0%) and 41 (19.3%), respectively; and decreased C3 in 23 (10.7%). Benzathine penicillin and penicillin V were used in 114 (53.5%) of children, non-steroidal anti-inflammatory drugs in 128 (59.8%) and parenteral/oral corticosteroids in 86 (40.2%). Immonusuppressives were given to 5 patients with nephrotic proteinuria following renal biopsy. Conclusions: Gastrointestinal and renal involvement in children with HSP, rarely lead to major complications.