Determination of Risk Factors in Children Diagnosed With  Henoch-Schönlein Purpura

Kılıç, Beltinge Demircioğlu

doi:10.5606/archrheumatol.2018.6562

Cited by 19 publications

(18 citation statements)

References 32 publications

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“…It affects both genders equally, and in some studies, there is a slightly male predominance. Male/female ratio was 1.08 in the study of Demircioglu Kilic et al [9] and this number was 1.36 in the cohort of Cakici et al [10]. Age and gender distribution in our study were compatible with the literature and the median age at diagnosis was 7.5 years and the male/female ratio was 1.15.…”

Section: Discussionsupporting

confidence: 89%

“…Wang et al [8] searched for risk factors for renal involvement in 2731 children with HSP and stated that age over six years, colder season, late diagnosis (more than eight days between the symptom onset and diagnosis), living in a rural area, recurrence, angioedema, and central nervous system involvement were the significant risk factors for renal involvement. Demircioglu Kilic et al [9] found that the risk of renal involvement was significantly higher in girls, in patients over 10 years, and in patients with elevated CRP. The meta-analysis of Chan et al [21] looked for risk factors for renal involvement in 13 studies (2398 children), and they concluded that male gender, diagnosis >10 years old, GI involvement, arthritis/arthralgia, persistent rash, relapse, elevated antistreptolysin O, low C3, WBC >15.000/mm 3 , and thrombocytes >500.000/mm 3 were associated with renal involvement.…”

Section: Discussionmentioning

confidence: 99%

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Initial manifestations and short term follow-up results of Henoch-Schönlein purpura in children: report from two centers.

Öztürk

Çakan

2020

North Clin Istanbul

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H enoch-Schönlein purpura (HSP), also known as IgA vasculitis, is the most common form of systemic vasculitis in children [1]. HSP is grouped under the rubric of small vessel vasculitis and typically involves skin, joints, kidneys and gut. The clinical spectrum may range from mild skin rash and arthralgia to severe gastrointestinal (GI) and renal involvement [1, 2]. All of the patients have a purpuric rash typically located on the legs and buttocks. The rash may also extend to the arms and face [1-3]. Sometimes, GI manifestations, such as abdominal pain or join manifestations like arthralgia or arthritis, may precede the development of a purpuric rash in less than 5% of the patients [3]. Other manifestations are low-grade fever, lethargy, myalgia, orchitis, sub-ABSTRACT OBJECTIVE: This retrospective observational study aims to demonstrate initial signs and symptoms of Henoch-Schönlein purpura (HSP), search for risk factors for gastrointestinal and renal involvement and give short term follow-up results. METHODS: The files of newly diagnosed HSP patients from two pediatric rheumatology centers in the southeastern part of the country were retrospectively analyzed in this study. Demographic, clinical features and laboratory results were recorded from the files. RESULTS: The cohort consisted of 323 children (males: 53.6%, females: 46.4%). Median age at the time of diagnosis was 7.5 (1.8-17.3) years and the median duration of follow-up was six (3-22) months. The rash was present in all cases but was not the first symptom in 22.9% of the cases. Arthritis and abdominal pain before the development of rash were the initial symptoms in 11.8% and 11.1% of the cases, respectively. Other manifestations were subcutaneous edema (63.2%), arthralgia (57.6%), arthritis (27.6%), myalgia (17.6%), lethargy (10.2%), orchitis (7.5%) and fever (5.3%). Gastrointestinal involvement was seen in 53.3% and renal involvement in 23.5% of the cases. None of the patients developed renal impairment during the follow-up. Older age at diagnosis, necrotic rash, subcutaneous edema, abdominal pain, lethargy, myalgia, arthralgia and arthritis were significantly higher in patients with renal involvement, but none of the demographic, clinical and laboratory features was an independent risk factor for renal or gastrointestinal involvement. CONCLUSION: Abdominal pain, arthritis may be the first manifestation of HSP. Having constitutional symptoms, such as fever, myalgia and lethargy at the time of diagnosis, may be warning signs of a more aggressive course with gastrointestinal and renal involvement.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Initial manifestations and short term follow-up results of Henoch-Schönlein purpura in children: report from two centers.

Öztürk

Çakan

2020

North Clin Istanbul

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“…Subcutaneous edema is the other prominent sign of HSP, with an overall frequency of 38.8-51.3%. 7,8,16,17 It an indication for corticosteroid therapy in patients with HSP. 1 In previous studies, the majority of subcutaneous edema was located in the extremities, followed by the head and neck 8 and back.…”

Section: Discussionmentioning

confidence: 99%

Sonographic Findings of Arthralgia in Children with Henoch-Schönlein Purpura

Seo¹,

Kim²,

Cho³

et al. 2020

Preprint

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Background Arthralgia is a common manifestation in children with Henoch–Schönlein purpura (HSP). No ultrasonographic (US) findings of arthralgia in patients with HSP have been reported. We therefore investigated these findings in affected joints of children with HSP. Methods The medical records of patients with HSP and arthralgia at Gyeongsang National University Hospital from 2014 to 2018 were reviewed for clinical data about arthralgia, anatomic location, US findings, treatment, and duration of improvement. Results Thirty-one patients underwent joint US imaging. Sixteen patients (51.6%) were aged 2–5 y, 10 (32.3%) were aged 6–10 y, and 5 (16.1%) were aged 11–17 y. Nineteen (61.3%) were boys and 12 (38.7%) were girls. The joint most commonly affected was the ankle (n = 25), followed by the knee (n = 6) and the foot or elbow. Four patients complained of knee and ankle pain simultaneously. Swelling, limited range of motion, tenderness, erythema, and febrile sensation in affected joints were observed in 22 patients (71.0%), 9 (29.0%), 21 (67.7%), 25 (80.6%), and 6 (19.4%), respectively. US images showed no visible joint effusion and no evidence of arthritis or synovitis, but it did show subcutaneous swelling with increased echo around affected joints. Arthralgia improved spontaneously in 6 patients and with corticosteroids in 25. Improvement in arthralgia lasted a mean of 1.9 ± 1.8 days. Conclusion US images showed subcutaneous edema around joints with neither joint effusion nor synovial inflammation.

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“… 1 A recent study of 186 children with IgA vasculitis identified girls, patients aged >10 years, and an increased C-reactive protein level as potential risk factors for IgA nephropathy. 2 Orchitis–Incorrect. IgA vasculitis can involve the male genitalia and induce inflammatory complications such as orchitis and epididymitis.…”

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confidence: 99%

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confidence: 99%