Henoch Schonlein purpura in children: an epidemiological study among Dutch paediatricians on incidence and diagnostic criteria

Aalberse, Joost A.; Dolman, Koerd; Ramnath, Gracita; Pereira, Rob Rodrigues; Davin, Jean–Claude

doi:10.1136/ard.2006.069187

Cited by 60 publications

(44 citation statements)

References 15 publications

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“…HSP can affect all age groups but most commonly children between 2 and 6 years of age [1,13]. The incidence in children is reported as between 10.5 and 20.4/100,000 children per year [5,13].…”

Section: Epidemiologymentioning

confidence: 99%

Clinical practice:

2009

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Henoch-Schönlein purpura (HSP) is the most common vasculitis of childhood. In this review, the main clinical features and complications are described. Although most features are self-limiting, renal disease is the most likely to result in long-term morbidity. Treatment of HSP nephritis is controversial, and the evidence for both prevention and treatment of established disease is reviewed. Follow-up for children presenting with HSP should be for at least 6 months and should include regular urine testing for proteinuria and haematuria and a blood pressure measurement. Women with a history of HSP during childhood are at increased risk of complications (such as proteinuria and hypertension) during pregnancy and should be monitored closely. This paper describes current practice with regard to investigation and management and proposes a practical care pathway of the management of a child with HSP.

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Section: Epidemiologymentioning

confidence: 99%

Clinical practice:

2009

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“…It is an immune-mediated systemic vasculitis of the small vessels with an estimated incidence in children of 10.5-20.4/100,000 per year, with peak incidence between ages 2 and 6 years. [1][2][3] There is a slight male preponderance (1.2:1), with a lower incidence in black children as compared with white or Asian children. 4 The pathogenesis of HSP is not yet clearly understood, although it is known to be an immune complexmediated disease.…”

Section: Discussionmentioning

confidence: 99%

A 10-Year-Old Girl with Gastrointestinal Hemorrhage

Possenti¹,

Borali²,

Longaretti³

et al. 2015

Pediatr Ann

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A 10-year-old girl presented to our hospital with arthralgia in the lower extremities and abdominal pain. Laboratory tests were normal. Urinalysis was negative for hematuria and proteinuria. Stool for occult blood test was negative. She was given oral ibuprofen for joint pain. On the same day she also presented with fever and sore throat, so she was given oral clavulanic-amoxicillin. After a few days she presented to our hospital with advanced polyarthralgias (affecting her wrists and ankles in particular) and two episodes of vomiting.She was admitted to our unit, at which point she suddenly presented with severe abdominal pain localized in the epigastric and the lower quadrant of her abdomen, leading to hematemesis and melena. On physical examination there were discreet general conditions, the abdomen was soft, and only deep palpation evoked diffuse moderate pain. Cardiac and lung findings were normal. The girl also presented with swollen and painful wrists and ankles, and a few purpuric lesions appeared on her lower extremities and eyelid.We suspended anti-inflammatory oral therapy and began omeprazole intravenously. We positioned nasogastric and rectal tubes. Laboratory tests revealed normal values of hemoglobin and coagulation parameters, C-reactive protein of 2.1 mg/dL (normal value <.5 mg/ dL), and normal renal and liver function. Urinalysis was negative for hematuria and proteinuria. Abdominal ultrasound showed thickening of the duodenal wall (Figure 1). Esophagogastroduodenoscopy showed multiple erosions in the duodenum with hyperemic gastric mucosa, and the biopsies were compatible with leukocytoclastic vasculitis (Figure 2). Steroid therapy with intravenous methylprednisolone at 2 mg/kg was started. The patient showed progressive improvement of her general condition in the first 24 hours, and 2 days later we removed the nasogastic tube and she began a liquid diet and then began to eat lighter foods. The patient was discharged from the hospital, and her laboratory and radiological follow-up results showed complete regression of the lesions after 3 weeks of steroid therapy (Figure 3).

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“…Studi sebelumnya melaporkan hasil serupa, yaitu 29%. 19 Rentang waktu antara kejadian nefritis dan onset PHS terbanyak pada ≥7 hari sampai dengan 30 hari. Hal tersebut serupa dengan studi sebelumnya yang melaporkan rentang <1 bulan (87%).…”

Section: Pembahasanunclassified

Faktor Prediktor Nefritis pada Anak dengan Purpura Henoch-Schonlein

Wardhana¹,

Satria

Hapsara

2017

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Latar belakang. Penyakit purpura Henoch-Schonlein (PHS) dapat menyebabkan komplikasi nefritis. Nefritis PHS dapat membaik sendiri atau berkembang menjadi penyakit ginjal kronik. Beberapa faktor prediktor telah diketahui berhubungan dengan kejadian nefritis PHS. Tujuan. Menentukan usia ≥10 tahun, purpura persisten, gejala abdomen berat dan relaps sebagai faktor prediktor nefritis pada PHS. Metode. Dilakukan studi kohort retrospektif. Sampel penelitian adalah anak berusia 1 tahun -18 tahun dengan PHS yang dirawat di Instalasi Kesehatan Anak RSUP Dr. Sardjito Yogyakarta periode Januari 2008-Agustus 2016 yang memenuhi kriteria inklusi. Sampel diambil secara konsekutif, kemudian diidentifikasi adanya faktor prediktor nefritis berdasarkan data rekam medis. Analisis bivariat untuk menghitung nilai p serta analisis multivariat dengan regresi logistik. Hasil. Diikutsertakan 80 pasien yang yang diikuti selama 6 bulan. Didapatkan nefritis pada 31 pasien (38,75%). Analisis bivariat dan multivariat menunjukkan bahwa hanya gejala abdomen berat yang merupakan faktor prediktor nefritis dengan nilai p=0,027 dan p=0,021, dan RR 3,759 (IK95%: 1,222-11,562). Kesimpulan. Gejala abdomen berat merupakan faktor prediktor pada kejadian nefritis PHS dan meningkatkan risiko 3,75 kali terjadinya nefritis PHS. Usia ≥10 tahun, purpura persisten, dan relaps tidak terbukti berpengaruh pada kejadian nefritis PHS. Sari Pediatri 2016;18(3):209-13Kata kunci: purpura Henoch-Schonlein, faktor prediktor, nefritis, gejala abdomen berat, purpura persiste Nephritis Predictive Factors in Children with Henoch-Schonlein PurpuraAhmad Wisnu Wardhana, Cahya Dewi Satria, Sunartini Background. Nephritis could be a complication of Henoch-Schonlein purpura (HSP). Henoch-schonlein purpura nephritis (HSPN) could be self limited or develop to chronic kidney disease. Some predictive factor for nephritis Henoch-Schonlein purpura has been identified . Objective. To determine age ≥ 10 years, persistent purpura, severe abdominal symptom and relaps are predictive factors for HSPN. Methods. A retrospective study was performed. Samples were children aged 1 years -18 years with HSP who came to the Pediatric Department of Dr. Sardjito hospital during January 2008-August 2016 and met the inclusion criteria. Samples were taken consecutively. We looked for the presence of predictive factors for HSP based on medical records. Bivariate analysis using chi-square test to calculate p value and multivariate analysis with logistic regression were conducted. Results. A total of 80 patients were included in the study. Their followed during six month after onset. There were 31 patients (38,75%) with nephritis. Bivariate and multivariate analysis showed that only severe abdominal symptom as a predictive factors for nephritis. (p value= 0,027 and p value=0,021, RR 3,759 95% CI 1,562). Conclusion. Severe abdominal symptom as a predictive factors for HSPN and it increase risk 3,7 times develop HSPN. Age ≥ 10 years at onset, persistent purpura and relapse were not affect HSPN. Sari Pediatri 20...

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Henoch Schonlein purpura in children: an epidemiological study among Dutch paediatricians on incidence and diagnostic criteria

Cited by 60 publications

References 15 publications

Clinical practice:

Clinical practice:

A 10-Year-Old Girl with Gastrointestinal Hemorrhage

Faktor Prediktor Nefritis pada Anak dengan Purpura Henoch-Schonlein

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