Kanuni Sultan Süleyman Research and Training Hospital, Department of Pediatric Rheumatology, University of Health Science, No: 46/1, Kucukcekmece, 34303, Istanbul, Turkey.
Kanuni Sultan Süleyman Research and Training Hospital, Department of Pediatric Nephrology, University of Health Science, Istanbul, Turkey.
Clin Rheumatol. 2019 Jun;38(6):1707-1714. doi: 10.1007/s10067-019-04460-1. Epub 2019 Feb 8.
Henoch-Schönlein purpura (HSP) is the most common vasculitis of children. The aim of this study is to evaluate the demographic and clinic findings of patients with HSP and also to determine predictive factors for assessing the development of gastrointestinal system (GIS) and renal involvement.
This study was performed prospectively among children with HSP who are under 18 years of age and being followed-up in the Pediatric Rheumatology Unit of Health Sciences University Kanuni Sultan Süleyman Training and Research Hospital between January 2016 and January 2018.
A total of 265 patients, 137 boys (51.7%) and 128 girls (48.3%), were involved to the study. The mean ± standard deviation of age at the diagnosis was 7.5 ± 3.2. The most common disease onset season was spring (31.7%). The rate of arthritis, GIS involvement, and renal involvement were 54%, 51.3%, and 29.1%, respectively. GIS bleeding was more frequent in males than females (p = 0.007). Boys over 7 years of age had significantly more common GIS bleeding (p = 0.04). Intussusception, relapse, and serious GIS involvement requiring hospitalization and steroid treatment were highly associated with severe renal involvement.
We demonstrated that patients suffering intussusception, relapse, and serious GIS involvement or requiring hospitalization and steroid treatment had tendency to present with severe renal involvement. Therefore, these patients should be followed up carefully for not overlooking renal involvement of HSP.
过敏性紫癜（HSP）是儿童最常见的血管炎。本研究旨在评估 HSP 患者的人口统计学和临床特征，并确定预测因子以评估胃肠道系统（GIS）和肾脏受累的发展。
本前瞻性研究纳入了 2016 年 1 月至 2018 年 1 月在健康科学大学 Kanuni Sultan Süleyman 培训和研究医院儿科风湿病科随访的 18 岁以下 HSP 患儿。
共有 265 例患儿（137 例男性，51.7%；128 例女性，48.3%）参与了本研究。诊断时的平均年龄为 7.5±3.2 岁。最常见的发病季节是春季（31.7%）。关节炎、GIS 受累和肾脏受累的发生率分别为 54%、51.3%和 29.1%。男性 GIS 出血的发生率高于女性（p=0.007）。7 岁以上的男孩 GIS 出血更为常见（p=0.04）。肠套叠、复发以及需要住院和类固醇治疗的严重 GIS 受累与严重肾脏受累高度相关。
我们发现患有肠套叠、复发以及严重 GIS 受累或需要住院和类固醇治疗的患者有发生严重肾脏受累的趋势。因此，应密切随访这些患者，以免漏诊 HSP 的肾脏受累。
