Common Vasculitis In Children Research Articles

Clinico-Laboratory Profile and Outcome of Kawasaki Disease in Children in a Tertiary Care Hospital in Kathmandu

Introduction: Kawasaki disease (KD) is one of the most common vasculitis of childhood. It contributes significantly to acquired heart disease in children and results in coronary artery abnormalities including aneurysm in 25% of untreated children. This study aims to retrospectively assess the clinical course, laboratory results, and presenting symptoms of patients with complete and incomplete KD treated at tertiary care hospital in Kathmandu.Method: This retrospective study was conducted in the Department of Pediatrics. Data from January 2020 to December 2020 were retrieved from medical records department of the hospital and analyzed using Microsoft excel.Result: The total number of cases evaluated in our study was 9. The median age at the time of the diagnosis of KD was 24 months (median age for incomplete KD-21 months, complete KD-37 months). Male to female ratio was 1.2:1. The peak season of KD occurrence was Spring (March – May). Mean duration of stay in the hospital was 7 days. All children presented with fever, with an mean fever duration of 7 days at the time of presentation. Fever was present in every case. The most common principal symptom was a polymorphous skin rash, observed in 88% of the cases. Elevated CRP levels (≥3 mg/dl) were noted in all 9 cases. Cardiovascular complications were present in 88% of the patients, with coronary artery aneurysm (CAA) detected in 11%, coronary artery dilation in 22%, and mild pericardial effusion documented in 66% of the cases. Eight patients (88%) received IVIG, all 9 patients (100%) received aspirin, and 2 patients received steroids. There were no fatalities.Conclusion: KD is a common vasculitis in children which do not have significant sex predilection in oppose to most of the studies. Majority of cases occurred in spring season. The most common symptom was polymorphous rash. A high level of suspicion for diagnosing KD is essential, and early treatment is crucial to prevent complications and reduce the future economic burden on families and the nation.

Fecal Calprotectin and the Complications of IgA-mediated Vasculitis: A Cohort Study

Background: Immunoglobulin A (IgA)-mediated vasculitis, previously known as Henoch-Schönlein Purpura (HSP), is the most common vasculitis in children. It affects the skin, joints, gastrointestinal (GI) system, and kidneys. Calprotectin is a calcium-binding protein mainly found in neutrophils and macrophages, and its levels increase in settings of inflammation. Objectives: We conducted a study to investigate the role of calprotectin in prediction of HSP complications. Methods: In this cohort study, patients diagnosed with HSP by EULAR/PRINTO/PRES criteria and admitted to two referral children’s hospitals in Tehran, Iran, were enrolled. Fecal calprotectin levels were checked at the beginning of the presentation, and the patients were followed for GI and renal manifestations. Results: Out of the 100 patients who began to participate, 47 were eventually enrolled (25% girls). The age range was 2 to 18 years, with a mean of 6.5 ± 2.9 years. Hematuria was found in 21% and proteinuria in 17%. The Mann-Whitney test found an association between calprotectin and blood in stool (P = 0.03). No association was found between calprotectin and abdominal pain, sonography findings, hematuria, or proteinuria. The Pearson correlation test found a positive correlation between calprotectin level and leukocyte count (P = 0.003), neutrophil count (P = 0.002), and CRP (P = 0.03). Conclusions: Positive blood in stool was associated with fecal calprotectin levels in HSP, but hematuria and proteinuria were not. Considering the high cost of the calprotectin test, monthly follow-up with urine analysis appears to be a more logical approach. Neutrophil count and CRP were found to correlate with calprotectin levels, highlighting the nature of calprotectin as an acute inflammatory marker elevated during the acute phase of HSP disease.

Standardization of the management ofrheumatoid purpura nephropathy in the West of France. What are the repercussions on the renal sequelae?

Rheumatoid purpura is the most common vasculitis in children, and its renal involvement determines the prognosis. To date, no national protocol exists for its management. A protocol was drafted for the French Grand Ouest inter-region in 2011 in order to standardize practices. The main objective is to evaluate renal sequelae with a median follow-up of 2 years since the implementation of this protocol. The secondary objectives are to evaluate the different therapeutic and diagnostic management. Inclusion of all children from 2006 to 2018 with nephropathy due to rheumatoid purpura followed in the university hospitals of Rennes, Nantes, Tours, Angers and Brest. 169 patients were included, of whom 104 were treated accroding to protocol and 65 differently. Sequels at 2-year follow-up concerned 27.0% of patients with no significant difference according to whether or not the protocol was followed. A significant decrease of 26.1% in the number of renal biopsies was observed in the group that followed the protocol. The latter was performed with a median delay of less than 30 days. The protocol allowed a standardization of practices without deleterious consequences at 2 years of follow-up and a decrease in renal biopsy punctures. It is in agreement with the recommendations of KDIGO (Kidney Disease Improving Global Outcomes) and European experts. On the other hand, in view of recent studies and the physiopathology, immunosuppressive drugs other than corticosteroids could be introduced earlier in severe forms.

Outcome of immunosuppression in children with IgA vasculitis-related nephritis.

Immunoglobulin A vasculitis with nephritis (IgAVN) is the most common vasculitis in children. Due to a lack of evidence, treatment recommendations are based on expert opinion, resulting in variation. The aim of this study was to describe the clinical presentation, treatment and outcome of an extremely large cohort of children with biopsy-proven IgAVN in order to identify prognostic risk factors and signals of treatment efficacy. Retrospective data were collected on 1148 children with biopsy-proven IgAVN between 2005 and 2019 from 41 international paediatric nephrology centres across 25 countries and analysed using multivariate analysis. The primary outcome was estimated glomerular filtration rate (eGFR) and persistent proteinuria at last follow-up. The median follow-up was 3.7 years (interquartile range 2-6.2). At last follow-up, 29% of patients had an eGFR <90mL/min/1.73 m2, 36% had proteinuria and 3% had chronic kidney disease stage 4-5. Older age, lower eGFR at onset, hypertension and histological features of tubular atrophy and segmental sclerosis were predictors of poor outcome. There was no evidence to support any specific second-line immunosuppressive regimen being superior to others, even when further analysing subgroups of children with reduced kidney function, nephrotic syndrome or hypoalbuminemia at onset. Delayed start of immunosuppressive treatment was associated with a lower eGFR at last follow-up. In this large retrospective cohort, key features associated with disease outcome are highlighted. Importantly, there was no evidence to support that any specific immunosuppressive treatments were superior to others. Further discovery science and well-conducted clinical trials are needed to define accurate treatment and improve outcomes of IgAVN.

Clinical course and management of children with IgA vasculitis with nephritis

BackgroundIgA vasculitis is the most common vasculitis in children and is often complicated by acute nephritis (IgAVN). Risk of chronic kidney disease (CKD) among children with IgAVN remains unknown. This study aimed to describe the clinical management and kidney outcomes in a large cohort of children with IgAVN.MethodsThis observational cohort study used the PEDSnet database to identify children diagnosed with IgAV between January 1, 2009, and February 29, 2020. Demographic and clinical characteristics were compared among children with and without kidney involvement. For children followed by nephrology, clinical course, and management patterns were described. Patients were divided into four categories based on treatment: observation, renin–angiotensin–aldosterone system (RAAS) blockade, corticosteroids, and other immunosuppression, and outcomes were compared among these groups.ResultsA total of 6802 children had a diagnosis of IgAV, of whom 1139 (16.7%) were followed by nephrology for at least 2 visits over a median follow-up period of 1.7 years [0.4,4.2]. Conservative management was the most predominant practice pattern, consisting of observation in 57% and RAAS blockade in 6%. Steroid monotherapy was used in 29% and other immunosuppression regimens in 8%. Children receiving immunosuppression had higher rates of proteinuria and hypertension compared to those managed with observation (p < 0.001). At the end of follow-up, 2.6 and 0.5% developed CKD and kidney failure, respectively.ConclusionsKidney outcomes over a limited follow-up period were favorable in a large cohort of children with IgAV. Immunosuppressive medications were used in those with more severe presentations and may have contributed to improved outcomes.Graphical abstractA higher resolution version of the Graphical abstract is available as Supplementary information

Cyclosporin A in combination with corticosteroids as a treatment for immunoglobulin A vasculitis nephritis in children.

Immunoglobulin A vasculitis is the most common vasculitis in children. It is usually a self-limiting condition, and the long-term prognosis depends on the severity of renal involvement. Although cyclosporin A is not generally recommended for the management of moderate immunoglobulin A vasculitis nephritis, a few previous reports showed its efficacy. Our aim was to determine whether the treatment with cyclosporin A in combination with corticosteroids is safe and effective for moderate pediatric immunoglobulin A vasculitis nephritis. Nine children underwent treatment. Mean follow-up was 3.1±1.6 (1.4-5.8) years. All children (seven females and two males) reached complete remission (65.8±27.6 [24-99]) days. No patient had relapse, one patient had slightly impaired kidney function (glomerular filtration rate 84.4 mL/min/1.73 m2), and two patients had microscopic hematuria without proteinuria at last follow-up. One patient with delayed treatment had microscopic hematuria at last follow-up and developed early albuminuria after cessation of immunosuppression. We observed no serious complications or side effects of the treatment. Cyclosporin A in combination with corticosteroids seems to be a safe and effective treatment for moderate immunoglobulin A vasculitis nephritis. More studies with cyclosporin A should be conducted to better determine the best therapeutic approach.

Diagnostic and Management Strategies of IgA Vasculitis Nephritis/Henoch-Schönlein Purpura Nephritis in Pediatric Patients: Current Perspectives.

IgA vasculitis (IgAV) or Henoch-Schönlein purpura (HSP) is the most common vasculitis in children, and nephritis (IgAVN or HSPN) is the most important and only chronic manifestation of the disease. Despite this, there are no diagnostic criteria and we rely on the European League Against Rheumatism/Paediatric Rheumatology International Trials Organization/Paediatric Rheumatology European Society-endorsed Ankara 2008 classification criteria in our daily practice. Basic investigations that should be done in every patient with IgAVN include blood pressure measurement, estimated glomerular filtration rate and urinalysis. Kidney biopsy is still the gold standard for the diagnosis of IgAVN since noninvasive confirmation of nephritis is still pending. According to the Single Hub and Access point for pediatric Rheumatology in Europe (SHARE) recommendations, the first-line treatment for with mild forms of IgAVN is oral glucocorticoids, for patients with moderate IgAVN parenterally administrated glucocorticoids in pulsed doses, while initial treatment for patients with the most severe forms of IgAVN include pulsed doses of glucocorticoids in combination with intravenous cyclophosphamide pulses. New therapeutic options are currently being tested, aiming to reduce the production of galactose-deficient IgA1 and autoantibodies or suppress the alternative or lectin complement pathway and blocking mesangial cell activation.

Predicting Severe Renal and Gastrointestinal Involvement in Childhood Immunoglobulin A Vasculitis with Routine Laboratory Parameters

Background: Immunoglobulin A vasculitis (IgAV) is the most common vasculitis in children. Although childhood IgAV is generally considered as a self-limited disease, progressive course and poor prognosis could occur in some cases which mostly result from severe renal involvement and gastrointestinal (GI) involvement. Methods: We performed a retrospective study of pediatric patients diagnosed as IgAV in our institution from 2016 to 2019. Patients were divided into groups based on the occurrence and severity of GI and renal involvement. Analysis of variance (ANOVA) and Kruskal-Wallis test were used to compare results of laboratory parameters among groups and prediction models were built by using logistic regression analysis. Results: A total of 286 patients were enrolled. GI involvement occurred in 148 (51.7%) patients, 30 (20.3%) of which were severe cases. Renal involvement developed in 120 (42.0%) patients, 22 (18.3%) of which were severe cases. Compared with patients with only cutaneous manifestations, white blood cell (WBC) count, neutrophil-to-lymphocyte ratio (NLR), and D-dimer levels were higher in those with GI involvement, and D-dimer level was found to be positively associated with severity. Increased NLR and lower complement 3 (C3) were found in patients with renal involvement, but only C3 was relevant in distinguishing moderate and severe cases. The prediction model for severe renal involvement was: Logit (P) = 6.820 + 0.270 (age) + 0.508 (NLR) − 16.130 (C3), with an AUC of 0.914. The prediction model for severe GI involvement was: Logit (P) = −5.459 + 0.005 (WBC) + 1.355 (D-dimer) – 0.020 (NLR), with an AUC of 0.849. Conclusion: Our data suggest C3 to be an exclusive predictor for severe renal involvement and D-dimer level to be positively associated with the severity of GI involvement. Prediction models consisting of the above parameters were built for obtaining prognostic information in the early phase of IgAV.

Predictive Value of Laboratory Indexes on Renal Involvement in Children with Henoch-Schönlein Purpura.

ObjectiveHenoch–Schönlein purpura (HSP) is the most common vasculitis in children. Renal involvement is the main long-term complication of HSP, and presently there is no way to predict which children may have irreversible renal damage from the outset. This study aimed to explore the prediction value of laboratory indexes on renal involvement in children with HSP, which could help the early identification and intervention.MethodsChildren with HSP hospitalized at the First Affiliated Hospital of Henan University of Chinese Medicine from June 2019 to December 2020 were included. The demographic findings, clinical features, laboratory findings including blood routine examination, serum immunoglobulin, complement, T cell subsets levels, liver and kidney function, coagulation function were recorded. Laboratory indexes were analyzed, logistic regression analysis was performed to identify the independent predictors in HSP patients with renal involvement, and receiver operating characteristic (ROC) curves were further used to assess the value of prediction indexes, as well as the efficacy of combined diagnosis.ResultsThe study included 146 HSP patients, among them, 50 patients (34.2%) had renal involvement. Age, platelet distribution width (PDW), CD3+ and fibrinogen (FIB) were positively correlated with renal involvement, while the levels of Immunoglobulin G (IgG), C-reactive protein (CRP), and neutrophil/lymphocyte ratio (NLR) were negatively correlated with renal involvement. The area under the ROC Curve (AUC) of these biomarkers ranged from 0.6284 to 0.7009, and among the combinations, a combination of NLR, CRP, CD3+, FIB, PDW, IgG and age had the best AUC value (0.9774).ConclusionAge, PDW, CD3+, FIB, CRP, NLR and IgG were prediction indexes for renal involvement in HSP patients, and these indexes can be combined appropriately to improve the diagnostic efficacy.

A Child with Immunoglobulin A Vasculitis and Hemorrhagic Shock

Immunoglobulin A (IgA) vasculitis, formerly known as Henoch–Schonlein purpura, is the most common vasculitis in children affecting small-sized vessels. Although IgA vasculitis is a self-limiting disease, a small number of patients can present with severe life-threatening complications. Here, we described a pediatric patient with final diagnosis of IgA vasculitis complicated with massive gastrointestinal bleeding and hemorrhagic shock, who recovered with supportive treatment and combined immunosuppressive drugs.

Immunoglobulin A Vasculitis Nephritis in Children: Experience from a Tertiary Care Hospital, Bangladesh

Background and Aim: Immunoglobulin A vasculitis (IgAV), formerly known as Henoch-Schonlein purpura (HSP),is the most common vasculitis in children with multiorgan involvement. Renal involvement is one of the important causes of morbidity and mortality. The objective of this study was to evaluate the frequency, clinical profile, and outcome of IgA vasculitis nephritis (IgAVN) in children. Methods:This prospective cross-sectional study was conducted in Dr. MRKhan Children Hospital & Institute of Child Health, Dhaka, over a period of 5years from January 2015 to December 2019. Data were collected using a structured questionnaire form and analyzed by the SPSS software version 20.0. Results:A total of 57cases of IgA vasculitis were admitted of whom 16 (28%) had renal involvement. The mean age was 7.7years. Regarding renal involvement, the majority of the patients (56.25%) had isolated hematuria. All nephritis patients (100%) had purpura and 75% of the patients had severe abdominal pain. The mean hematocrit and the mean platelet count were significantly higher in the nephritis group compared to patients without nephritis (41.49±4.47vs.39.98±5.16, p-value<0.005 and485.51±58.29 vs. 293.89±65.15, p-value<0.001, respectively). The level of complement C3 was significantly lower in the nephritis group compared to patients without nephritis (0.85±0.4 vs. 1.5±0.3, p-value <0.01). The majority (68.75%) of the patients recovered and 18.75% were in remission with immunosuppressant. None of the cases progressed to ESRD. Conclusion:Severe abdominal pain, high platelet counts, high hematocrit levels, and low C3 concentrations are common findings in nephritis. Nephritis resolvespontaneously in most cases but severe nephritis requires treatment with immunosuppressive drugs for remission.

An Atypical Cause of Abdominal Pain in an Elderly Patient

Background: Henoch-Schonlein Purpura (HSP), or IgA vasculitis, is the most common vasculitis in children and is characterized by four symptoms: palpable purpura with no concurrent thrombocytopenia or coagulopathy, arthritis/ arthralgias, abdominal pain, and renal disease. HSP does occur in older patients at a much lower frequency. Objective: To discuss the atypical presentation of HSP in an elderly adult and the increased nephrogenic risks that are involved in this patient group. Case Presentation: We present the history, physical findings, laboratory results, and the clinical course of a 74-year-old Caucasian male with an atypical presentation of HSP. Our patient presented with severe gastrointestinal and cutaneous symptoms which occurred after the onset of abdominal pain. Biopsies demonstrated leukocytoclastic vasculitis in the skin and acute inflammation and hemorrhage in the gastrointestinal tract. The diagnosis was confirmed as IgA vasculitis following the renal biopsy. The patient’s symptoms improved with the administration of methylprednisolone. Conclusion: In adults with HSP there is greater concern regarding renal involvement and a greater risk of developing end-stage renal disease compared to children. The importance of recognizing HSP in the elderly is imperative for early diagnosis and appropriate treatment to limit renal damage.

Early recognition and treatment of Henoch-Schönlein purpura in children.

Henoch-Schönlein purpura (HSP) is characterised by a non-blanching rash, which commonly affects the lower limbs of children aged 3-15 years. It is the most common vasculitis in children. HSP often develops after an upper respiratory tract infection and is more likely to present in autumn, winter and spring. The majority of cases resolve with symptomatic treatment although some cases may progress to serious complications, including renal involvement. A case study is presented and differential diagnoses are explored. The pathophysiology of HSP is discussed. Nurses are often the first to assess patients so they are in an ideal position to recognise and treat HSP early on. Admission of a child into hospital is a stressful event for the parents and child; the nurse can help by ensuring prompt admission to hospital and offering support and reassurance to the family.

P094 Henoch–Schonlein purpura and inflammatory bowel disease

BACKGROUND: Approximately 7.5% of children with inflammatory bowel disease (IBD) develop cutaneous extra-intestinal manifestations, with erythema nodosum, pyoderma gangrenosum, and psoriasis being the most common. Although rare, cases of cutaneous small-vessel vasculitis in children with IBD have been reported. CASE: An 8 Y/M with ileo-colonic Crohn disease presented with 3 days of bilateral lower extremity swelling and 1 day of tender palpable rash on the right arm, chest and dorsal surface of the right foot. Crohn disease was diagnosed at age 5 years and was on mesalamine for treatment at the time of presentation. A year ago he had been on infliximab infusions, but had to stop the treatment after a severe infusion reaction. On exam, patient was uncomfortable, unable to bear weight, afebrile, and without abdominal pain or tenderness to palpation. He had limited range of motion of right foot secondary to pain. No joint swelling was noted. He had a palpable purpuric rash on his right arm, chest and dorsal surface of the right foot. Urinalysis was positive for trace protein and ketones. His ANA titers were positive and rheumatoid factor was negative. A clinical diagnosis of Henoch-Schonlein purpura (HSP) was made based on the typical rash and urinalysis. He was treated symptomatically with acetaminophen and did well subsequently DISCUSSION: HSP occurs in approximately 10–22 persons/100,000 each year. More than 90% of patients are children younger than 10 years, with a peak incidence at 6 years of age. HSP is the most common vasculitis in children and has a slight predominance in males. The clinical features of HSP are a consequence of widespread leukocytoclastic vasculitis owing to immunoglobulin A deposition in vessel walls. In 15% to 20% of patients, the gastrointestinal symptoms precede the diagnostic rash by a number of days. In such patients, IBD is a diagnostic consideration, even though the coexistence of HSP and IBD is quite uncommon. In this report, we describe a child with Crohn disease who developed HSP 3 years after diagnosis. HSP can be seen as a complication of infliximab or adalimumab therapy, but our patient was not on biologic therapy at the time HSP diagnosis.

Direct Immunofluorescence Results of the Skin Biopsy and Frequency of Systemic Involvement in Children with Henoch-Schonlein Purpura

Objective: Henoch-Schonlein purpura (HSP) is a common vasculitis in children that can present with multi-organ involvement. The aim of this study is to investigate the correlation between direct immunofluorescence (DIF) results and the systemic involvements of the HSP in pediatric patients.Material and Methods: Those HSP patients with leukocytoclastic vasculitis on their biopsies who also had documented immunoglobulin/complementdeposition by DIF were included in our study. Their demographic and laboratory data and clinical manifestations were recorded and analyzed.Results: Medical records of 95 patients (1.5–15 years old) were studied. 26.3% of the patients showed renal, 86.3% articular, and 70.3% gastrointestinal involvement. The risk of renal involvement was significantly higher in those with C3 deposition in their skin DIF. IgM deposition was mostly associated with articular involvement.Conclusion: Pediatric HSP patients who had C3 deposition in their skin DIF should be selected for further evaluation regarding HSP nephritis.

Henoch-Schouml;nlein purpura presenting as organic gastric outlet obstruction case report

Henoch-Schönlein purpura (HSP) is an acute small vessel vasculitis. It is the most common vasculitis in children, with an annual incidence of about 10 cases per 100.000 children. Although gastrointestinal manifestations are common, gastric outlet obstruction is never reported. The authors present the case of a 13-y-old boy having coffee ground vomitus, melenic stools and pyloric stenosis. Improvement of symptoms was achieved by conservative management with steroid therapy and gastric decompression.

IgA vasculitis, formerly known as Henoch-Schönlein purpura – the most common vasculitis in children

IgA vasculitis, formerly known as Henoch-Schönlein purpura – the most common vasculitis in children

Atypical Kawasaki Disease in a 4 Years Old Child with Mumps

Kawasaki disease is an acute febrile condition seen in children. However, it is also well recognized that some patients do not fulfill the classic diagnostic criteria for the diagnosis of Kawasaki disease. The incomplete form of Kawasaki disease is termed as 'Incomplete KD' or 'Atypical KD'. This is a case of 4 years old child with fever and mumps. He had bilateral cervical adenitis. Patient failed to respond to IV antibiotics fulfilled the criteria of incomplete Kawasaki disease. The child was managed with high dose aspirin until the child was afebrile for 48 hours. Kawasaki disease is a common vasculitis in children. Atypical cases might be missed if there is concomitant viral illness. Hence the identification and management of Kawasaki disease is paramount to decrease the mortality related to the cardiac disease. Keywords: bilateral cervical adenitis; fever and mumps; failed to respond IV antibiotics; incomplete kawasaki disease.

Distribution of circulating T follicular helper cell subsets is altered in immunoglobulin A vasculitis in children.

BackgroundImmunoglobulin A vasculitis (IgAV) is the most common vasculitis in children. Previously, we demonstrated that patients with IgAV show abnormal proliferation of cluster of differentiation (CD)4+C-X-C chemokine receptor type (CXCR)5+ follicular helper T (Tfh) cells. Here, we explored the status of Tfh cell subsets and plasma cytokine levels in patients with IgAV.MethodsCD4+CXCR5+CD45RA−, CD45RA-CXCR3+CCR6−, CD45RA−CXCR3−CCR6−, CD45RA−CXCR3−CCR6+, and CD45RA−CXCR3+CCR6+ Tfh cell fractions and plasma concentrations of interferon-γ, interleukin (IL)-4, and IL-17A were evaluated by flow cytometry and a flow cytometric bead array, respectively, in 30 patients with IgAV and 15 healthy controls (HCs).ResultsTfh2 and Tfh17 cell fractions were larger and the Tfh2+Tfh17/Tfh1 ratio and plasmaIL-4 and -17A levels were higher in patients with IgAV than in the HCs. Only Tfh1 cell counts were reduced in the abdominal subtype. The elevations in Tfh2 and Tfh17 cell counts and plasma IL-4 levels were abrogated by treatment. Tfh2 cell number was positively correlated with serum IgA and plasma IL-4 levels, but negatively correlated with the serum C4 concentration, while Tfh17 cell number was positively correlated with the serum IgA level and Tfh2 cell counts.ConclusionsAbnormally high numbers of Tfh2 and Tfh17 cells are linked to the occurrence and development of IgAV, but are not specific to the abdominal type. Only Tfh1 cells play a critical role in abdominal-type IgAV.

Prevalence of kidney involvement during the first year of follow-up in patients with Henoch-Schönlein purpura in a pediatric institution in Bogotá, Colombia

Abstract Introduction Henoch-Schonlein purpura is the most common vasculitis in children, with kidney involvement remaining the main cause of morbidity and mortality. The spectrum of kidney involvement ranges from mild symptoms to the development of a nephrotic and/or nephritic syndrome or kidney failure. Objective To determine the clinic features at onset, and kidney involvement of patients with a final diagnosis of Henoch-Schonlein purpura during the first month, 3 months, and up to the first year of follow-up. Methods A retrospective study conducted on patients with a final diagnosis of Henoch-Schonlein purpura in a Pediatric Rheumatology Department in an institution of Bogota, Colombia, during the period between 2010 and 2016. Results The study included 86 patients, 42 girls and 44 boys. The median age at disease onset was 5.3 years (SD 2.4 years: range 1–14 years). Kidney involvement was present in 39/86 (45%) patients. A trend to kidney involvement was observed in patients with abdominal symptoms (p = 0.053). The most frequent clinical finding was isolated proteinuria (49%), followed of proteinuria/hematuria (28%), and isolated hematuria (15%). Renal biopsy was performed on 8/39 patients with Henoch-Schonlein purpura nephritis. The mean follow-up was 26.8 months (SD 17 months: range 1–72). There was no evidence of kidney damage in the last assessment in any of the 39 patients with kidney involvement. Conclusion In this group of patients, kidney involvement was more severe and common in the first weeks of the disease onset.