Clinical manifestations and outcomes of 420 children with Henoch Schonlein Purpura from a single referral center from Turkey: A three-year experience


KIŞLA EKİNCİ R. M., Balci S., MELEK E., KARABAY BAYAZIT A., DOĞRUEL D., ALTINTAŞ D. U., ...More

MODERN RHEUMATOLOGY, vol.30, no.6, pp.1039-1046, 2020 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 30 Issue: 6
  • Publication Date: 2020
  • Doi Number: 10.1080/14397595.2019.1687074
  • Journal Name: MODERN RHEUMATOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, Academic Search Premier, EMBASE, MEDLINE
  • Page Numbers: pp.1039-1046
  • Keywords: Colchicine, Henoch Schonlein Purpura, IgA vasculitis, nephritis, relapse, CHILDHOOD, CLASSIFICATION, VASCULITIDES, IGA
  • Çukurova University Affiliated: Yes

Abstract

Objectives: Henoch Schonlein Purpura (HSP) is the most common systemic vasculitis in childhood. We aimed to evaluate the clinical features, seasonal variation, treatment outcomes and the possible predicting factors related to outcome among a large cohort of pediatric HSP patients. Methods: We conducted a medical record review study between July 2016 and January 2019 and evaluated the clinical manifestations and potential risk factors for severe gastrointestinal (GI) involvement, biopsy-proven nephritis and relapses. Results: The study included 420 HSP patients, of which the mean age at diagnosis was 7.68 +/- 3.15 years. Clinical manifestations were arthralgia and/or arthritis (n = 244, 58.1%), abdominal pain (n = 235, 56%), subcutaneous edema (n = 163, 38.8%), and renal involvement (n = 125, 29.8%). Disease recurred for at least once, in 69 (16.4%) patients and colchicine treatment yielded a favorable response in 11 of 12 relapsing patients, who did not respond to ibuprofen or steroids. Frequencies of renal involvement and biopsy-proven nephritis were higher in patients with severe GI involvement. Besides, patients with biopsy-proven nephritis had higher rates of abdominal pain, intussusception, severe GI involvement, and systemic steroid administration. Conclusion: We speculate that renal involvement, biopsy-proven nephritis and severe GI involvement can be related to each other. Colchicine may be effective in patients with relapsing disease.