Clinical Profile of Henoch-Schonlein Purpura in Children

Abstract

BACKGROUND Henoch-Schonlein purpura (HSP) is the most common systemic vasculitis in children. It can produce multisystem involvement. The disease is usually self-limited, but can occasionally produce life-threatening gastrointestinal and renal manifestations. The aim of the study is to describe the age of onset and clinical profile of HSP in children. MATERIALS AND METHODS This is a retrospective descriptive study conducted in a tertiary care hospital. 61 children below 12 years who were admitted over a 2-year period with a diagnosis of HSP based on American College of Rheumatology criteria were included in the study. The clinical details were collected from the case records and entered in a proforma. Data was analysed statistically. RESULTS The mean age of presentation was 6.7 years. The male-to-female ratio was 1.2: 1. The commonest clinical features were purpura (100%), abdominal pain (70%) and arthritis (65%). Renal involvement was seen in 5%. Anaemia was seen in 48%, raised ESR in 50% and thrombocytosis in 20%. Steroids were used in treatment in 55% of patients. CONCLUSION The clinical profile of HSP in children was similar to that found in other studies except for renal involvement, which showed much lower incidence in this study. Gastrointestinal manifestations and arthritis may occasionally be the presenting features of HSP even before appearance of rash. Steroids were used in more than half of the patients with HSP.