Clinical Manifestations and Outcomes of Henoch-Schonlein Purpura: Comparison between Adults and Children

被引:75
作者
Hung, Shih-Pin [1 ,2 ]
Yang, Yao-Hsu [1 ]
Lin, Yu-Tsan [1 ]
Wang, Li-Chieh [1 ]
Lee, Jyh-Hong [1 ]
Chiang, Bor-Luen [1 ]
机构
[1] Natl Taiwan Univ Hosp, Dept Pediat, Taipei 100, Taiwan
[2] Cathay Gen Hosp, Dept Pediat, Taipei, Taiwan
关键词
adult; children; Henoch-Schonlein purpura; nephrotic syndrome; nephritis; PREDICTIVE FACTORS; RENAL INVOLVEMENT; FOLLOW-UP; NEPHRITIS; VASCULITIS; FEATURES; DISEASE; RISK;
D O I
10.1016/S1875-9572(09)60056-5
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Background: Henoch-Schonlein purpura (HSP) primarily affects children, but age at onset is thought to be important in determining disease severity and outcome. This study compared the clinical and laboratory data from children and adults with HSP. Methods: This retrospective 5-year study enrolled 65 children and 22 adult HSP patients attending a medical center. Results: Gross hematuria and lower-extremity edema were significantly more frequent in adults (p<0.05). All the children developed renal involvement within 2 weeks, while 67% of the adult patients developed hematuria by the fifth week of disease onset. Elevated white blood cell count and increased erythrocyte sedimentation rate were significantly more common in children (p<0.05). Adults had a higher frequency of renal involvement (p<0.05), though this was also present in 14 children (21.54%), 12 with isolated hematuria and proteinuria and two with nephrotic syndrome. All the children maintained normal renal function. Twelve adults had renal involvement (52.6%), six with progression to renal insufficiency. Patients with abdominal pain at disease onset had a significantly higher probability of developing nephrotic syndrome (p<0.05). Logistic regression revealed that age >20 years, mate, bloody stools, clinical course with relapse of purpuric rash, and persistent rash for >1 month were poor prognostic indicators for HSP nephritis (p<0.05). Conclusions: HSP nephritis in adults had a higher risk of progression to renal insufficiency. More aggressive treatment and extended follow-up with repeated urinalysis for at least 6 weeks were often necessary, especially in older patients.
引用
收藏
页码:162 / 168
页数:7
相关论文
共 27 条
  • [1] ANAPHYLACTOID PURPURA IN CHILDREN (SCHONLEIN-HENOCH SYNDROME)
    ALLEN, DM
    DIAMOND, LK
    HOWELL, DA
    [J]. AMA JOURNAL OF DISEASES OF CHILDREN, 1960, 99 (06): : 833 - 854
  • [2] Henoch-Schonlein purpura in children from northwestern Spain -: A 20-year epidemiologic and clinical study
    Calviño, MC
    Llorca, J
    García-Porrúa, C
    Fernández-Iglesias, JL
    Rodriguez-Ledo, P
    González-Gay, MA
    [J]. MEDICINE, 2001, 80 (05) : 279 - 290
  • [3] Long-term prognosis of Henoch-Schonlein nephritis in adults and children
    Coppo, R
    Mazzucco, G
    Cagnoli, L
    Lupo, A
    Schena, FP
    [J]. NEPHROLOGY DIALYSIS TRANSPLANTATION, 1997, 12 (11) : 2277 - 2283
  • [4] Cutaneous vasculitis: a review
    Crowson, AN
    Mihm, MC
    Magro, CM
    [J]. JOURNAL OF CUTANEOUS PATHOLOGY, 2003, 30 (03) : 161 - 173
  • [5] Henoch-Schonlein purpura nephritis
    Fervenza, FC
    [J]. INTERNATIONAL JOURNAL OF DERMATOLOGY, 2003, 42 (03) : 170 - 177
  • [6] Comparative clinical and epidemiological study of hypersensitivity vasculitis versus Henoch-Schonlein purpura in adults
    García-Porrúa, C
    González-Gay, MA
    [J]. SEMINARS IN ARTHRITIS AND RHEUMATISM, 1999, 28 (06) : 404 - 412
  • [7] Henoch-Schonlein Purpura in children and adults:: Clinical differences in a defined population
    García-Porrúa, C
    Calviño, MC
    Llorca, J
    Couselo, JM
    González-Gay, MA
    [J]. SEMINARS IN ARTHRITIS AND RHEUMATISM, 2002, 32 (03) : 149 - 156
  • [8] García-Porrúa C, 2001, J RHEUMATOL, V28, P1019
  • [9] LONG-TERM FOLLOW-UP OF CHILDHOOD HENOCH-SCHONLEIN NEPHRITIS
    GOLDSTEIN, AR
    WHITE, RHR
    AKUSE, R
    CHANTLER, C
    [J]. LANCET, 1992, 339 (8788) : 280 - 282
  • [10] HABBIB R, 1989, RENAL PATHOLOGY CLIN, P427