Gardner-Medwin Janet M M, Dolezalova Pavla, Cummins Carole, Southwood Taunton R
Department of Rheumatology, University of Birmingham, Birmingham, UK.
Lancet. 2002 Oct 19;360(9341):1197-202. doi: 10.1016/S0140-6736(02)11279-7.
The frequency and ethnic variation of Henoch-Schönlein purpura, Kawasaki disease, and rarer vasculitides during childhood are not well characterised. Our aim was to ascertain the incidence and ethnic distribution of these conditions in children resident in a region of the UK with a diverse ethnic mix.
1.1 million children younger than age 17 years live in the West Midlands. Between Sept 1, 1996, and Aug 31, 1999, we surveyed this population with monthly questionnaires sent to 321 consultants, a single questionnaire sent to 2860 family doctors, and review of 406 case notes with diagnostic codes for vasculitis. We included in the analyses children who fulfilled established criteria for vasculitis with disease onset during the study, and calculated incidence rates from population rates derived from the census of 1991.
We identified 586 new instances of vasculitis and connective tissue disease. The estimated annual incidence of Henoch-Schönlein purpura was 20.4 per 100000, and was highest between the ages of 4 years and 6 years (70.3 per 100000). The estimated annual incidence of Kawasaki disease was 5.5 per 100000 in children younger than 5 years, and was highest in Indian subcontinent Asian children (14.6 per 100000). Indian subcontinent Asian and black children had the highest incidence of systemic lupus erythematosus, juvenile dermatomyositis, and other primary systemic vasculitides.
Childhood Henoch-Schönlein purpura is more frequent in the West Midlands than previously reported, and Kawasaki disease has a higher incidence than previously indicated in the UK, with the highest incidence in Indian subcontinental Asian children. Other vasculitis is rare in childhood.
儿童期过敏性紫癜、川崎病及其他罕见血管炎的发病频率和种族差异尚无充分描述。我们的目的是确定居住在英国一个种族多样化地区的儿童中这些疾病的发病率和种族分布情况。
西米德兰兹郡有110万名17岁以下儿童。在1996年9月1日至1999年8月31日期间，我们通过每月向321名顾问发送调查问卷、向2860名家庭医生发送一份调查问卷以及查阅406份带有血管炎诊断编码的病例记录，对该人群进行了调查。我们将研究期间发病且符合既定血管炎标准的儿童纳入分析，并根据1991年人口普查得出的人口率计算发病率。
我们确定了586例新的血管炎和结缔组织病病例。过敏性紫癜的估计年发病率为每10万人20.4例，在4岁至6岁儿童中最高（每10万人70.3例）。5岁以下儿童川崎病的估计年发病率为每10万人5.5例，在印度次大陆亚洲儿童中最高（每10万人14.6例）。印度次大陆亚洲儿童和黑人儿童系统性红斑狼疮、幼年皮肌炎及其他原发性系统性血管炎的发病率最高。
西米德兰兹郡儿童期过敏性紫癜的发病率高于此前报道，川崎病的发病率高于英国此前指出的发病率，在印度次大陆亚洲儿童中发病率最高。其他血管炎在儿童期较为罕见。
