Document Type : original article
1 Professore of pediatric nephrology, Children and Adolescents Health research center, Research Institute of cellular and Molecular Science in Infectious Diseases , Zahedan University of Medical Science's, Zahedan, Iran.
2 Children and Adolescents Health research center, Research Institute of cellular and Molecular Science in Infectious Diseases , Zahedan University of Medical Science&#039;s, Zahedan, Iran
3 Pediatric Nephrologists, Pediatric Wards, Ali ebne Abitalib Hospital, School of Medicine, Zahedan University of Medical Science's, Zahedan, Iran
4 MD ,Razi Hospital in Saravan, Sistan and Baluchestan Province, Iran
Background: The most prevalent form of systemic vasculitis in children is Henoch–Schönlein Purpura (HSP), also known as IgA vasculitis, with different manifestations. This study was performed to assess the clinical course of Henoch–Schönlein purpura in south east of Iran.
Methods: The clinical data of 221 children under age 18 years who were diagnosed with HSP at Ali Ebne Abi Taleb hospital in Zahedan, Iran, was analyzed for a ten-year period. Clinical manifestations, laboratory measures and different types of treatments were recorded from the patients’ profiles with some useful additional information. Skin purpura, acute arthritis or arthralgia, gastrointestinal involvement, and renal involvement were the criteria for examination. Data description was performed by the use of SPSS 23.00.
Results: Mean age of the patients was 7.37 ± 3.19 years at diagnosis and 51.13% of them were girls. About 23.8% and 98.6% of the patients had a history of upper respiratory infections and palpable purpura, respectively. Fever was detected in 25.2% of the children. About 28.5% had vomiting and 13.6% had diarrhea. Renal involvement was observed in 130 children. During the course of the disease, 53.8% received prednisolone and 21.7% received pulse methylprednisolone due to severe GI symptoms or renal involvement. Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) were administered to 19.45% of the patients.
Conclusion: The patients' sex ratio was close to 1:1, though girls slightly outnumbered boys. Most HSP patients had Joint symptoms, GI symptoms and renal involvement. Arthralgias were the initial manifestations. Multicenter prospective studies with a larger number of patients are recommended to confirm the results.
- Roache-Robinson P, Hotwagner DT. Henoch Schönlein Purpura. InStatPearls [Internet] 2021 Aug 11. StatPearls Publishing.
- Aviel YB, Dafna L, Pilar G, Brik R. Endothelial function in children with a history of henoch schonlein purpura. Pediatric Rheumatology. 2017 Dec; 15(1):3.
- Hetland CE, Susrud KS, Lindahl KH, Bygum A. Henoch-Schönlein purpura: a literature review. Acta dermato-venereologica. 2017 Nov 1; 97(8-9):1160-6.
- Wang JJ, Xu Y, Liu FF, Wu Y, Samadli S, Wu YF, Luo HH, Zhang DD, Hu P. Association of the infectious triggers with childhood Henoch–Schonlein purpura in Anhui province, China. Journal of Infection and Public Health. 2020 Jan 1; 13(1):110-7.
- Hetland LE, Susrud KS, Lindahl KH, Bygum A. Henoch-Schönlein Purpura: A Literature Review. Acta dermato-venereologica, 2017, 97.10.
- Gómez S, Pérez M, Pellegrini M, Isern E, Quintana C, Artacho P, Bertolini M, Pomerantz B, Gadda N. Henoch-Schonlein Purpura in Pediatrics: Ten Years of Experience at a Moderate Risk Office of a General Hospital. Arch Argent Pediatr. 2020 Feb 1; 118(1):31-7.
- Du L, Wang P, Liu C, Li S, Yue S, Yang Y. Multisystemic manifestations of IgA vasculitis. Clinical Rheumatology. 2021 Jan; 40(1):43-52.
- Mossberg M, Segelmark M, Kahn R, Englund M, Mohammad AJ. Epidemiology of primary systemic vasculitis in children: a population-based study from southern Sweden. Scand J Rheumatol 2018; 47(4):295–302.
- Piram M, Maldini C, Biscardi S, De Suremain N, Orzechowski C, Georget E, Regnard D, Koné-Paut I, Mahr A. Incidence of IgA vasculitis in children estimated by four-source capture-recapture analysis: a population-based study. Rheumatology (Oxford) 2017; 56(8):1358–66
- Shim JO, Han K, Park S, Kim GH, Ko JS, Chung JY. Ten-year nationwide population-based survey on the characteristics of children with Henoch–Schonlein ¨ purpura in Korea. J Korean Med Sci 2018; 33(25):e174.
- Kiliç BD, Demir BK. Determination of risk factors in children diagnosed with Henoch-Schönlein purpura. Archives of Rheumatology. 2018 Dec; 33(4):395
- Ekinci RM, Balci S, Sari Gokay S, Yilmaz HL, Dogruel D, Altintas DU, Yilmaz M. Do practical laboratory indices predict the outcomes of children with Henoch-Schönlein purpura?. Postgraduate Medicine. 2019 May 19; 131(4):295-8.
- Sano H, Izumida M, Shimizu H, Ogawa Y. Risk factors of renal involvement and significant proteinuria in Henoch-Schönlein purpura. European journal of pediatrics. 2002 Apr; 161:196-201.
- Kaku Y, Nohara K, Honda S. Renal involvement in Henoch-Schönlein purpura: a multivariate analysis of prognostic factors. Kidney international. 1998 Jun 1; 53(6):1755-9.
- Kim WK, Kim CJ, Yang EM. Risk factors for renal involvement in Henoch-Schönlein purpura. Jornal de pediatria. 2021 Dec 6; 97:646-50.
- Abbas S, Geetha S, Deepthi RV, Kamar J, Uthup S. Clinical profile and outcome of Henoch Schonlein purpura in a tertiary care hospital in South India. International Journal of Contemporary Pediatrics. 2017 May; 4(3):822-6.
- Ozturk K, Çakan M. Initial manifestations and short term follow-up results of Henoch-Schönlein purpura in children: A report from two centers. Northern Clinics of İstanbul. 2020 Jun 1; 7(4):341-7.
- Huang X, Wu X, Le W, Hao Y, Wu J, Zeng C, Liu Z, Tang Z. Renal prognosis and related risk factors for henoch-schönlein purpura nephritis: a Chinese adult patient cohort. Scientific Reports. 2018 Apr 3; 8(1):1-8.
- Gökçe Ş, Kurugöl Z, Koturoğlu G, Aslan A. Predictive role of laboratory markers and clinical features for recurrent Henoch-Schönlein Purpura in childhood: A study from Turkey. Modern Rheumatology. 2020 Nov 1; 30(6):1047-52.
- Fu W, Ye W, Liu X, Zhu S, Fu H, Zhu R, Li H, Zeng H, Wang Q. Meta-analysis of the neutrophil-to-lymphocyte and platelet-to-lymphocyte ratios in Henoch-Schonlein purpura and its complications. International Immunopharmacology. 2021 May 1; 94:107454.
- Zhao Y, Yadav PK, Pan Y, Niu S, Zhang S, Wang H, Wang Z. Analysis of 135 cases of pediatric henoch-schönlein purpura in gansu, northwestern china. Iranian Journal of Pediatrics. 2019 Dec 31; 29(6).
- Alizadeh H, Ranjbar M, Ziaee V, Mohsenipour R, Mehdizadeh M, Moradinejad MH, Sabbaghian M, Alimadadi H. The relationship between sonographic findings, and clinical and paraclinical symptoms in Henoch Schonlein purpura. Iranian Journal of Pediatrics. 2017 Apr 30; 27(2).
- Demir S, Candan C, Turhan P, Ergüven M. Henoch Schönlein Purpura/Ig A Vasculitis in Children and Risk Factors for Renal Involvement. Acta Medica. 2021 Aug 27; 52(3):230-8.
- Zhang, X., Nima, Z., Zhang, S., Suona, W., Pubu, C. and Yu, S. (2021) Efficacy Analysis of Glucocorticoids in the Treatment of Allergic Purpura in Tibetan Children. International Journal of Clinical Medicine, 12, 14-22.
- Breda, L., Carbone, I., Casciato, I. Gentile C, Grasso EA, Donato Gd, Chiarelli F, Verrotti A. Epidemiological and clinical aspects of immunoglobulin a vasculitis in childhood: a retrospective cohort study. Ital J Pediatr 47, 237 (2021). https://doi.org/10.1186/s13052-021-01182-6