J Asthma Allergy Clin Immunol.
1998 Dec;18(4):672-680.
A clinical study of Henich-Schonlein purpura in childhood
Abstract
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BACKGROUND AND OBJECTIVE: The clinical manifestation of Henoch-Schonlein purpura and existance of renal
involvement may influence on its course and prognosis. To verify prevention with early
administration of steroid, we studied the efficacy of corticosteroid treatment.
MATERIAL AND METHOD: We analysed 65 children under 15 years of age with Henoch-Scho nlein
purpura according to their age, sex, and seasonal incidence. Forty children showed typical
skin lesions, arthralgia and abdominal pain. We have divided them two groups. Group A
consisted of 20 children who received 1 mg/kg of prednisolone/perday for 2 weeks and
group B did not. We carried out their physical examination and urinalysis monthly for a year.
RESULT: The main clinical manifestations were skin rash(100% ), abdominal symptoms(41.5 %),
joint symptoms (49.2%), and renal involvement(34%). As for gastrointestinal symptoms,
abdominal pain(66.7% ) was most commonly observed one and others were nausea or vomiting
(44.7%) and melena(25.9%). The joint involvement was observed mostly in knee(56.3%) and
ankle joint(31.3% ), Hematuria was observed in all cases with renal involvement and
proteinuria, in 28% of them. The improvement of renal manifestations were noted in 84.2%
of them within 4 months. Mild elevation of IgA was more frequently observed in renal
involvement group than non-involved group (p< 0.01). There were no significant
differences in immonologic parameters such as IgG, IgM, IgE, duration of the acute phase
and severity of cutaneous symptoms between two growps. None of steroid treated growp
showed progression of nephropathy. Of the 20 non-steroid treated growp, 2(10%) developed
nephropathy. Conclusion We may suggest that existance of renal involvement in Henoch-Schonlein
purpura influences its course and prognosis.