Henoch Schonlein purpura in childhood: clinical analysis of 254 cases over a 3-year period
Henoch Schonlein purpura in childhood: clinical analysis of 254 cases over a 3-year period
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DOI：
10.1007/s10067-008-0868-2
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发表时间：
2008-09-01
影响因子：
3.4
通讯作者：
Hasanoglu, Enver
中科院分区：
文献类型：
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作者：
Peru, Harun;Soylemezoglu, Oguz;Hasanoglu, Enver
我们的目的是评估诊断为过敏性紫癜(HSP)的患者的关节、胃肠道(GI)和肾脏受累的疾病特征和预后。对2003-01-2006-06在塞尔库克大学梅拉姆医学院和加齐大学医学院儿科肾病门诊就诊的254名确诊为过敏性紫斑狼疮的儿童进行了回顾性评估。对肾活检患者的临床随访和治疗方案进行了详细的评价。研究组由254名儿童组成，其中男孩147名(57.8%)，女孩107名(42.2%)，男女比例为1.37。皮肤、关节、胃肠道和肾脏表现的比例分别为100%、66%、56%和30%。8例患者发生肠套叠。其中5例仅经类固醇治疗痊愈，3例接受手术治疗。64名胃肠道受累患者(44%)患有严重疾病，并成功地接受了类固醇治疗。26例患者行肾活检。26例患者中，2例分别在3周和4周内自行恢复。10例患者仅用激素治疗后好转，12例患者用激素加环磷酰胺治疗后痊愈。2例患者对激素和环磷酰胺耐药，接受环孢素A治疗。我们认为，对有胃肠道症状的HSP患者给予激素治疗可能有助于预防可能的并发症，如胃肠道出血和肠套叠。此外，类固醇和环磷酰胺的联合治疗通常是肾病蛋白尿患者的合适治疗方法。
We aimed to evaluate the patients who were diagnosed as Henoch Schonlein purpura (HSP) for disease characteristics and prognosis of those with joint, gastrointestinal (GI), and renal involvement. Two hundred and fifty-four children who were followed up with the diagnosis of HSP in the Pediatric Nephrology Clinics of Meram Medical Faculty of Selcuk University and Medical Faculty of Gazi University between January 2003 and June 2006 were retrospectively evaluated. The clinical follow-up and treatment regimens of patients in whom renal biopsy was performed were evaluated in detail. The study group consisted of 254 children, 147 boys (57.8%) and 107 girls (42.2%), and the ratio of boys to girls was 1.37. The percentages of skin, joint, GI, and renal manifestations were 100%, 66%, 56%, and 30%, respectively. Eight patients had intussusception. Five of them recovered with steroid treatment only while three patients were operated on. Sixty-four patients (44%) with GI involvement had severe disease and were successfully treated with steroids. Renal biopsy was performed in 26 patients. Among those 26 patients, two of them recovered spontaneously within 3 and 4 weeks. Ten patients improved with only steroid treatment while 12 patients recovered with steroid and cyclophosphamide treatment. Two patients were resistant to steroid and cyclophosphamide treatment and were treated with cyclosporine A. We believe that steroid therapy given to the HSP patients with GI manifestations might be helpful to prevent probable complications such as GI bleeding and intussusception. In addition, combined therapy with steroid and cyclophosphamide can usually be an appropriate treatment for patients with nephrotic proteinuria.