Henoch-Schonlein purpura and drug and vaccine use in childhood: a case-control study
Henoch-Schonlein purpura and drug and vaccine use in childhood: a case-control study
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DOI：
10.1186/s13052-016-0267-2
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发表时间：
2016-06-18
影响因子：
3.6
通讯作者：
Menniti-Ippolito, Francesca
中科院分区：
文献类型：
--
作者：
Da Dalt, Liviana;Zerbinati, Claudia;Menniti-Ippolito, Francesca
背景资料：过敏性紫癜（Henoch-Schonlein purpura，HSP）是儿童期最常见的血管炎，其病因和发病机制尚不清楚，尽管有多种因素，主要是感染因子、药物和疫苗被认为是该病的诱因。本研究的目的是估计HSP与药物和疫苗管理在儿科population.Methods：积极监测儿童的药物和疫苗的安全性正在进行中的11个临床中心在意大利。所有因选定的关注急性临床疾病通过当地儿科急诊科住院的儿童均入组本研究。通过家长访谈收集儿童在出现导致住院的症状前的药物和疫苗使用情况。采用病例对照设计进行风险估计：将HSP儿童（作为病例）的暴露与胃十二指肠病变儿童（作为对照）的类似暴露进行比较。根据EULAR/PRINTO/PRES标准对HSP病例进行验证。结果：在研究期间（1999年11月至2013年4月），288例病例和617例对照被纳入。估计任何药物均不会增加HSP的风险。结论：麻疹-腮腺炎-风疹（MMR）疫苗可增加HSP的发病风险（OR 3.4，95%CI 1.2-10.0）。
Background: Henoch-Schonlein purpura (HSP) is the most common vasculitis in childhood; nevertheless, its etiology and pathogenesis remain unknown despite the fact that a variety of factors, mainly infectious agents, drugs and vaccines have been suggested as triggers for the disease. The aim of this study was to estimate the association of HSP with drug and vaccine administration in a pediatric population.Methods: An active surveillance on drug and vaccine safety in children is ongoing in 11 clinical centers in Italy. All children hospitalized through the local Paediatric Emergency Department for selected acute clinical conditions of interest were enrolled in the study. Data on drug and vaccine use in children before the onset of symptoms leading to hospitalization were collected by parents interview. A case-control design was applied for risk estimates: exposure in children with HSP, included as cases, was compared with similar exposure in children with gastroduodenal lesions, enrolled as controls. HSP cases were validated according to EULAR/PRINTO/PRES criteria. Validation was conducted retrieving data from individual patient clinical record.Results: During the study period (November 1999-April 2013), 288 cases and 617 controls were included. No increased risk of HSP was estimated for any drug. Among vaccines, measles-mumps-rubella (MMR) vaccine showed an increased risk of HSP (OR 3.4; 95 % CI 1.2-10.0).Conclusions: This study provides further evidence on the possible role of MMR vaccine in HSP occurrence.