Demircioğlu Kiliç Beltinge, Kasap Demir Belde
Department of Child Health and Diseases, Division of Pediatric Nephrology, Medicine Faculty of Gaziantep University, Gaziantep, Turkey.
Department of Pediatric Nephrology and Rheumatology, Katip Çelebi University, İzmir, Turkey.
Arch Rheumatol. 2018 Jan 30;33(4):395-401. doi: 10.5606/ArchRheumatol.2018.6562. eCollection 2018 Dec.
This study aims to evaluate the frequency of skin, gastrointestinal, joint, and renal involvement in children with Henoch-Schönlein purpura and investigate the risk factors for organ/system involvement.
The data of 186 patients (97 boys, 89 girls; mean age 7.4±2.8 years; range 1.5 to 16.5 years) who were followed-up with the diagnosis of Henoch-Schönlein purpura in our clinic between October 2011 and December 2013 were evaluated retrospectively.
Logistic regression analysis revealed that the risk of gastrointestinal system involvement was significantly higher in patients with skin lesions in the upper extremities (p=0.002, odds ratio [OR]=3.2). The risk of joint involvement was significantly higher in girls (p=0.024, OR=2.18), in patients with soft tissue swelling (p=0.005, OR=2.63), and with low mean platelet volume levels (p=0.008, OR=4.07). The risk of renal involvement was significantly higher in girls (p=0.047, OR=2.7), in patients >10 years (p=0.001, OR=1.4), and in patients with elevated C-reactive protein levels (p=0.007, OR=6.57).
Having skin lesions in the upper extremities is a risk factor for gastrointestinal system involvement. Female sex, soft tissue swelling, and low mean platelet volume levels are risk factors for joint involvement. Female sex, >10 years of age, and high C-reactive protein levels are risk factors for renal involvement. Renal involvement in Henoch-Schönlein purpura is independent of gastrointestinal system or joint involvement and very close follow-up is required in the acute period particularly in girls >10 years with high C-reactive protein levels.
本研究旨在评估过敏性紫癜患儿皮肤、胃肠道、关节和肾脏受累的频率,并调查器官/系统受累的危险因素。
回顾性评估2011年10月至2013年12月期间在我院门诊确诊为过敏性紫癜并接受随访的186例患者(97例男孩,89例女孩;平均年龄7.4±2.8岁;范围1.5至16.5岁)的数据。
逻辑回归分析显示,上肢有皮肤病变的患者胃肠道系统受累风险显著更高(p=0.002,比值比[OR]=3.2)。女孩(p=0.024,OR=2.18)、有软组织肿胀的患者(p=0.005,OR=2.63)以及平均血小板体积水平低的患者(p=0.008,OR=4.07)关节受累风险显著更高。女孩(p=0.047,OR=2.7)、年龄>10岁的患者(p=0.001,OR=1.4)以及C反应蛋白水平升高的患者(p=0.007,OR=6.57)肾脏受累风险显著更高。
上肢有皮肤病变是胃肠道系统受累的危险因素。女性、软组织肿胀和平均血小板体积水平低是关节受累的危险因素。女性、年龄大于10岁和C反应蛋白水平高是肾脏受累的危险因素。过敏性紫癜的肾脏受累独立于胃肠道系统或关节受累,急性期尤其需要对年龄>10岁且C反应蛋白水平高的女孩进行密切随访。