Henoch Schönlein Purpura in children: Clinical features and risk factors for renal involvement
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Published:
Jul 30, 2018
Keywords:
Henoch Schönlein purpura risk factors Renal involvement
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Abstract
Objective: This study aimed to evaluate the clinical and laboratory features of children diagnosed with Henoch Schönlein purpura (HSP), risk factors of renal involvement and their effect on prognosis.
Methods: A total of 80 pediatric HSP patients (44 males and 36 females) between ages 2 to 13 (average age 7.68±3.09) admitted to the Pediatrics Clinic and follow-up cases from the Pediatric Rheumatology and Nephrology Clinic of the Istanbul Medeniyet University, Göztepe Training and Research Hospital, between April 1998 and June 2003 were enrolled for the study. In order to precisely evaluate glomerular and tubular function, urinary β 2 microglobulin, microalbumin and tubular reabsorption of phosphorus (TRP) were determined.
Results: A retrospective evaluation of the HSP patients showed that 26 (32.5%) had symptoms of renal impairment. In terms of renal function, 20 (25%) out of the 54 asymptomatic children initially subjected to routine renal tests had renal involvement. In terms of age, there was a significant difference (p < 0.016) in developing renal involvement between patients above 5 years old and those younger than 5 years.
Conclusion: It was therefore suggested that long-term follow-ups in addition to examinations such as routine kidney function tests, tubular reabsorption of phosphate (TRP) and microalbumin levels should be conducted in order to detect the early phase of renal damage.
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How to Cite
Fedakar, A. . (2018). Henoch Schönlein Purpura in children: Clinical features and risk factors for renal involvement. Medical Science and Discovery, 5(7), 267–273. Retrieved from https://medscidiscovery.com/index.php/msd/article/view/262
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Research Article
References
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2. Kılıç BD , Demir BK. Determination of Risk Factors in Children Diagnosed With Henoch-Schönlein Purpura. Arch Rheumatol 2018;33(x):i-vii.
3. Choi SM, Lee KY. Clinico-epidemiologic study of Henoch-Schonlein purpura in children, 1987 through 2003. Korean J Pediatr 2005;48:174-7.
4. H. L.Yong , Yu B. K. Yu, W. K.Ja ,Chung J. Y. Henoch-Schonlein Purpura in Children Hospitalized at a Tertiary Hospital during 2004-2015 in Korea: Epidemiology and Clinical Management . Pediatr Gastroenterol Hepatol Nutr 2016 September 19(3):175-85.
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7. Narchi H. Risk of long term renal impairment and duration of follow up recommended for Henoch-Schönlein purpura with normal or minimal urinary findings: a systematic review. Arch Dis Child. 2005 Sep; 90(9): 916–20.
8. Mills JA, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 .Criteria for classification of Henoch-Schönlein purpura. Arthritis Rheum 1990;33: 1114-21.
9. Mao Y, Yin L, Huang H, Zhou Z, Chen T, Zhou W. Henoch-Schonlein purpura in 535 Chinese children: clinical features and risk factors for renal involvement. J Int Med Res 2014;42: 1043-9.
10. Yılmaz A, Aytaç M B, Ekinci Z. Retrospective Assessment of Children with Henoch-Schonlein Purpura in and around Kocaeli Province and Comparison with Literature. Erciyes Med J 2014 36(2): 62-7 • DOI: 10.5152/etd.2013.63.
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12. Yong H L, Yu BK, Yu WK, Chung J Y. Henoch-Schonlein Purpura in Children Hospitalized at a Tertiary Hospital during 2004-2015 in Korea: Epidemiology and Clinical Management . Pediatr Gastroenterol Hepatol Nutr 2016 September 19(3):175-85.
13. Kızıldağ İ. Henoch schönlein purpurası nefritinde prognostik faktörler TC. Çukurova Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim dalı.ADANA- 2015.
14. Kılıç B D, Demir BK. Determination of Risk Factors in Children Diagnosed With Henoch-Schönlein Purpura. Arch Rheumatol 2018;33(x):i-vii.
15. Allen DM, Diamond LK, Howell DA. Anaphylactoid purpura in chil¬dren (Schonlein-Henoch syndrome): review with a follow-up of the renal complications. AMA J Dis Child 1960; 99: 833-54.
16. Pohl M. Henoch-Schonlein purpura nephritis. Pediatr Nephrol 2014.
17. Tabel Y, Inanc FC, Dogan DG, Elmas AT. Clinical features of children with Henoch-Schonlein purpura: risk factors associated with renal involvement. Iran J Kidney Dis 2012;6:269-74.
18. Chan H, Tang YL, Lv XH, Zhang GF, Wang M, Yang HP, et al. Risk Factors Associated with Renal Involvement in Childhood HenochSchönlein Purpura: A Meta-Analysis. PLoS One 2016;11:0167346.
19. Uppal SS, Hussain MA, Al-Raqum HA, Nampoory MR, Al-Saeid K, Al-Assousi A, et al. Henoch-Schönlein's purpura in adults versus children/adolescents: A comparative study. Clin Exp Rheumatol 2006;24(2 Suppl 41):S26-30.
20. Anil M, Aksu N, Kara OD, Bal A, Anil AB, Yavascan O, et al. Henoch-Schönlein purpura in children from western Turkey: a retrospective analysis of 430 cases. Turk J Pediatr 2009; 51:429-36.
21. Nuhoğlu Ç, Gedikoğlu H, Sönmez EO, Ozkozacı T, Ceran O. Henoch-Schönlein Purpurası olan çocuk olguların demografik özellikleri ve laboratuar bulgularının retrospektif analizi. Haydarpaşa Numune Eğitim ve Araştırma Hastanesi Tıp Dergisi 2009;49(2):125-9.
22. Gairdner D.The Schönlein – Henoch syndrome (anaphylactoid purpura).Q JMed 1948 ;17:95-122.
23. AlSheyyab M, E Shanti H,Ajlovni S, Batieha A, Daoud AS. Henoch-Schönlein Purpura:cinical association.Trop Padiatr 1996;42:200-3.
24. Ronkainen J, Nuutinen M, Koskimies O. The adult kidney 24 years after childhood Henoch–Scho¨nlein purpura: a retrospective cohort study. Lancet 2002; 360: 666–70.
25. Schärer K. Krmar R. Querfeld U Ruder H Waldherr R. Schaefer F. Clinical outcome of Schonlein-Henoch purpura nephritis in children. Pediatric nephrology (Berlin, Germany) 13, 816–23.
26. Tsuruga K, Watanabe S, Oki E, et al. Imbalance towards Th1 pathway predominance in purpura nephritis with proteinuria. Pediatr Nephrol 2011; 26: 2253–8
27. Chen JY, Mao JH. Henoch-Schönlein purpura nephritis in children: incidence, pathogenesis and management. World J Pediatr 2015;11(1):29-34.
28. Gürgöze MK, Gündüzalp M. Henoch-Schönlein Purpura in the Children: The evaluation retrospective of 50 patients. Fırat Tıp Dergisi 2010; 15:27-30.
29. Anil M, Aksu N, Kara OD, Bal A, Anil AB, Yavascan O, et al. Henoch-Schönlein purpura in children from western Turkey: a retrospective analysis of 430 cases. Turk J Pediatr 2009; 51:429-36.
30. Shin JI, Park JM, Shi YH, Hwang DH, Kim JH, Lee JS. Predictive factors for nephritis, relapse, and significant proteinuria in childhood Henoch-Schönlein purpura. Scand J Rheumatol 2006; 35: 56-60.
31. Akl K. Childhood Henoch Schonlein purpura in Middle East countries. Saudi J Kidney Dis Transpl 2007;18:151-8.
32. Lanzkowsky S.Lanzkowsky L, Lanzkowsky P. Henoch-Schönlein purpura.pediat Rew 1992;13(4): 130-7.
33. Fischer PJ, Hagge W, Hecker W.Schönlein-Henoch purpura. A clinical study of 119 paients with special reference to unusual complications.Medicine (Baltimore). 1999.78(6):395-09,
34. Sönmez F,Mir s, cura A, cakır d, Başdemir G. Clinocopathologic correlations of Henoch Schönlein nephritis in Turkish children. Pediatr Int. 1999 Aug;41(4):353-6. Muller D, Greve D, Eggert P. Early tubular proteinuria and the development of nephritis in Henoch-Schönlein purpura. Pediatr Nephrol. 2000 Nov;15(1-2):85-9.
2. Kılıç BD , Demir BK. Determination of Risk Factors in Children Diagnosed With Henoch-Schönlein Purpura. Arch Rheumatol 2018;33(x):i-vii.
3. Choi SM, Lee KY. Clinico-epidemiologic study of Henoch-Schonlein purpura in children, 1987 through 2003. Korean J Pediatr 2005;48:174-7.
4. H. L.Yong , Yu B. K. Yu, W. K.Ja ,Chung J. Y. Henoch-Schonlein Purpura in Children Hospitalized at a Tertiary Hospital during 2004-2015 in Korea: Epidemiology and Clinical Management . Pediatr Gastroenterol Hepatol Nutr 2016 September 19(3):175-85.
5. Onat T. Henoch-Schönlein vasküliti. Çocuk Sağlığı ve Hastalıkları. Eksen Yayınları 1996; 2: 987–9.
6. Yılmaz A. Aytaç M. B., Ekinci Z. Retrospective assessment of children with henoch-schonlein purpura in and around kocaeli province and comparison with literature. Erciyes Med J 2014 36(2): 62-7.
7. Narchi H. Risk of long term renal impairment and duration of follow up recommended for Henoch-Schönlein purpura with normal or minimal urinary findings: a systematic review. Arch Dis Child. 2005 Sep; 90(9): 916–20.
8. Mills JA, Michel BA, Bloch DA, et al. The American College of Rheumatology 1990 .Criteria for classification of Henoch-Schönlein purpura. Arthritis Rheum 1990;33: 1114-21.
9. Mao Y, Yin L, Huang H, Zhou Z, Chen T, Zhou W. Henoch-Schonlein purpura in 535 Chinese children: clinical features and risk factors for renal involvement. J Int Med Res 2014;42: 1043-9.
10. Yılmaz A, Aytaç M B, Ekinci Z. Retrospective Assessment of Children with Henoch-Schonlein Purpura in and around Kocaeli Province and Comparison with Literature. Erciyes Med J 2014 36(2): 62-7 • DOI: 10.5152/etd.2013.63.
11. Acar B Ç, Arıkan Y, Arıkan FD, Dallar Y . System involvement evaluation of 168 case which is observed with henoch schönlein vasculitis in childhood. Ege Journal of Medicine 49 (1): 7-12, 2010.
12. Yong H L, Yu BK, Yu WK, Chung J Y. Henoch-Schonlein Purpura in Children Hospitalized at a Tertiary Hospital during 2004-2015 in Korea: Epidemiology and Clinical Management . Pediatr Gastroenterol Hepatol Nutr 2016 September 19(3):175-85.
13. Kızıldağ İ. Henoch schönlein purpurası nefritinde prognostik faktörler TC. Çukurova Üniversitesi Tıp Fakültesi Çocuk Sağlığı ve Hastalıkları Anabilim dalı.ADANA- 2015.
14. Kılıç B D, Demir BK. Determination of Risk Factors in Children Diagnosed With Henoch-Schönlein Purpura. Arch Rheumatol 2018;33(x):i-vii.
15. Allen DM, Diamond LK, Howell DA. Anaphylactoid purpura in chil¬dren (Schonlein-Henoch syndrome): review with a follow-up of the renal complications. AMA J Dis Child 1960; 99: 833-54.
16. Pohl M. Henoch-Schonlein purpura nephritis. Pediatr Nephrol 2014.
17. Tabel Y, Inanc FC, Dogan DG, Elmas AT. Clinical features of children with Henoch-Schonlein purpura: risk factors associated with renal involvement. Iran J Kidney Dis 2012;6:269-74.
18. Chan H, Tang YL, Lv XH, Zhang GF, Wang M, Yang HP, et al. Risk Factors Associated with Renal Involvement in Childhood HenochSchönlein Purpura: A Meta-Analysis. PLoS One 2016;11:0167346.
19. Uppal SS, Hussain MA, Al-Raqum HA, Nampoory MR, Al-Saeid K, Al-Assousi A, et al. Henoch-Schönlein's purpura in adults versus children/adolescents: A comparative study. Clin Exp Rheumatol 2006;24(2 Suppl 41):S26-30.
20. Anil M, Aksu N, Kara OD, Bal A, Anil AB, Yavascan O, et al. Henoch-Schönlein purpura in children from western Turkey: a retrospective analysis of 430 cases. Turk J Pediatr 2009; 51:429-36.
21. Nuhoğlu Ç, Gedikoğlu H, Sönmez EO, Ozkozacı T, Ceran O. Henoch-Schönlein Purpurası olan çocuk olguların demografik özellikleri ve laboratuar bulgularının retrospektif analizi. Haydarpaşa Numune Eğitim ve Araştırma Hastanesi Tıp Dergisi 2009;49(2):125-9.
22. Gairdner D.The Schönlein – Henoch syndrome (anaphylactoid purpura).Q JMed 1948 ;17:95-122.
23. AlSheyyab M, E Shanti H,Ajlovni S, Batieha A, Daoud AS. Henoch-Schönlein Purpura:cinical association.Trop Padiatr 1996;42:200-3.
24. Ronkainen J, Nuutinen M, Koskimies O. The adult kidney 24 years after childhood Henoch–Scho¨nlein purpura: a retrospective cohort study. Lancet 2002; 360: 666–70.
25. Schärer K. Krmar R. Querfeld U Ruder H Waldherr R. Schaefer F. Clinical outcome of Schonlein-Henoch purpura nephritis in children. Pediatric nephrology (Berlin, Germany) 13, 816–23.
26. Tsuruga K, Watanabe S, Oki E, et al. Imbalance towards Th1 pathway predominance in purpura nephritis with proteinuria. Pediatr Nephrol 2011; 26: 2253–8
27. Chen JY, Mao JH. Henoch-Schönlein purpura nephritis in children: incidence, pathogenesis and management. World J Pediatr 2015;11(1):29-34.
28. Gürgöze MK, Gündüzalp M. Henoch-Schönlein Purpura in the Children: The evaluation retrospective of 50 patients. Fırat Tıp Dergisi 2010; 15:27-30.
29. Anil M, Aksu N, Kara OD, Bal A, Anil AB, Yavascan O, et al. Henoch-Schönlein purpura in children from western Turkey: a retrospective analysis of 430 cases. Turk J Pediatr 2009; 51:429-36.
30. Shin JI, Park JM, Shi YH, Hwang DH, Kim JH, Lee JS. Predictive factors for nephritis, relapse, and significant proteinuria in childhood Henoch-Schönlein purpura. Scand J Rheumatol 2006; 35: 56-60.
31. Akl K. Childhood Henoch Schonlein purpura in Middle East countries. Saudi J Kidney Dis Transpl 2007;18:151-8.
32. Lanzkowsky S.Lanzkowsky L, Lanzkowsky P. Henoch-Schönlein purpura.pediat Rew 1992;13(4): 130-7.
33. Fischer PJ, Hagge W, Hecker W.Schönlein-Henoch purpura. A clinical study of 119 paients with special reference to unusual complications.Medicine (Baltimore). 1999.78(6):395-09,
34. Sönmez F,Mir s, cura A, cakır d, Başdemir G. Clinocopathologic correlations of Henoch Schönlein nephritis in Turkish children. Pediatr Int. 1999 Aug;41(4):353-6. Muller D, Greve D, Eggert P. Early tubular proteinuria and the development of nephritis in Henoch-Schönlein purpura. Pediatr Nephrol. 2000 Nov;15(1-2):85-9.