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Henoch-Schonlein Purpura in Children Hospitalized at a Tertiary Hospital during 2004-2015 in Korea: Epidemiology and Clinical Management

Yu Bin Kim|Ju-Young Chung|Yong Hee Lee|Ja Wook Koo
대한소아소화기영양학회 (The Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition)|2016.09|Pediatric Gastroenterology, Hepatology & Nutrition|제19권 제3호|pp. 175-185

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참고문헌

키워드

ChildSigns and symptomsPrognosisNephritisPurpuraSchonlein-Henochdigestive
주제분류소아과학

초록

Purpose: To investigate the epidemiology, clinical manifestations, investigations and management, and prognosis of patients with Henoch-Schonlein purpura (HSP).Methods: We performed a retrospective review of 212 HSP patients under the age of 18 years who were admitted to Inje University Sanggye Paik Hospital between 2004 and 2015.Results: The mean age of the HSP patients was 6.93 years, and the ratio of boys to girls was 1.23:1. HSP occurred most frequently in the winter (33.0%) and least frequently in the summer (11.3%). Palpable purpura spots were found in 208 patients (98.1%), and gastrointestinal (GI) and joint symptoms were observed in 159 (75.0%) and 148 (69.8%) patients, respectively. There were 57 patients (26.9%) with renal involvement and 10 patients (4.7%) with nephrotic syndrome. The incidence of renal involvement and nephrotic syndrome was significantly higher in patients with se-vere GI symptoms and in those over 7 years old. The majority of patients (88.7%) were treated with steroids. There was no significant difference in the incidence of renal involvement or nephrotic syndrome among patients receiving different doses of steroids. Conclusion: In this study, the epidemiologic features of HSP in children were similar to those described in previous studies, but GI and joint symptoms manifested more frequently. It is essential to carefully monitor renal involvement and progression to chronic renal disease in patients ≥7 years old and in patients affected by severe GI symptoms. It can be assumed that there is no direct association between early doses of steroids and prognosis.

Abstract

Purpose: To investigate the epidemiology, clinical manifestations, investigations and management, and prognosis of patients with Henoch-Schonlein purpura (HSP).Methods: We performed a retrospective review of 212 HSP patients under the age of 18 years who were admitted to Inje University Sanggye Paik Hospital between 2004 and 2015.Results: The mean age of the HSP patients was 6.93 years, and the ratio of boys to girls was 1.23:1. HSP occurred most frequently in the winter (33.0%) and least frequently in the summer (11.3%). Palpable purpura spots were found in 208 patients (98.1%), and gastrointestinal (GI) and joint symptoms were observed in 159 (75.0%) and 148 (69.8%) patients, respectively. There were 57 patients (26.9%) with renal involvement and 10 patients (4.7%) with nephrotic syndrome. The incidence of renal involvement and nephrotic syndrome was significantly higher in patients with se-vere GI symptoms and in those over 7 years old. The majority of patients (88.7%) were treated with steroids. There was no significant difference in the incidence of renal involvement or nephrotic syndrome among patients receiving different doses of steroids. Conclusion: In this study, the epidemiologic features of HSP in children were similar to those described in previous studies, but GI and joint symptoms manifested more frequently. It is essential to carefully monitor renal involvement and progression to chronic renal disease in patients ≥7 years old and in patients affected by severe GI symptoms. It can be assumed that there is no direct association between early doses of steroids and prognosis.

참고문헌 (40)

  1. Saulsbury FT, "Henoch-Schönlein purpura", Curr Opin Rheumatol, 13, pp.35~40 (2001)
  2. Rostoker G, "Schönlein-Henoch purpura in children and adults: diagnosis, pathophysiology and management", Bio Drugs, 15, pp.99~138 (2001)
  3. Huber AM, "A randomized, placebo-controlled trial of prednisone in early Henoch Schönlein purpura", BMC Med, 2, pp.7~ (2004)
  4. Ronkainen J, "Early prednisone therapy in henoch-schönlein purpura: a randomized, double-blind, placebo-controlled trial", J Pediatr, 149, pp.241~247 (2006)
  5. Weiss PF, "Effects of corticosteroid on Henoch-Schönlein purpura: a systematic review", Pediatrics, 120, pp.1079~1087 (2007)
  6. Calvo-Río V, "Henoch-Schönlein purpura in northern Spain: clinical spectrum of the disease in 417 patients from a single center", Medicine (Baltimore), 93, pp.106~113 (2014)
  7. Lu S, "Comparison between adults and children with Henoch- Schönlein purpura nephritis", Pediatr Nephrol, 30, pp.791~796 (2015)
  8. Shin JI, "Predictive factors for nephritis, relapse, and significant proteinuria in childhood Henoch-Schönlein purpura", Scand J Rheumatol, 35, pp.56~60 (2006)
  9. 홍주희, "Henoch-Schnlein Purpura에서 연령에 따른 임상 양상 및 예후에 관한 고찰", Korean Journal of Pediatrics, 48(11), pp.1244~1251 (2005), 대한소아과학회
  10. Cohen N, "Predictors of hospital length of stay in pediatric Henoch- Schönlein purpura", Rheumatol Int, 35, pp.1561~1564 (2015)
  11. 오재민, "진단 전에 자반이 동반되지 않았던 Henoch-Sch nlein 자반 위장병증의 임상적 고찰", Pediatric Gastroenterology, Hepatology & Nutrition, 7(1), pp.54~60 (2004), 대한소아소화기영양학회
  12. 양혜란, "스테로이드 치료에 반응하지 않는 심한 위장관 증세의 Henoch-Sch nlein 자반증 환아에서 정맥 면역글로불린 치료", Korean Journal of Pediatrics, 49(7), pp.784~789 (2006), 대한소아과학회
  13. Jauhola O, "Cyclosporine A vs. methylprednisolone for Henoch-Schönlein nephritis: a randomized trial", Pediatr Nephrol, 26, pp.2159~2166 (2011)
  14. Kawasaki Y, "Plasmapheresis therapy for rapidly progressive Henoch-Schönlein nephritis", Pediatr Nephrol, 19, pp.920~923 (2004)
  15. Park JM, "Cyclosporin A therapy for Henoch-Schönlein nephritis with nephrotic- range proteinuria", Pediatr Nephrol, 26, pp.411~417 (2011)
  16. Cherqaoui B, "Intravenous immunoglobulins for severe gastrointestinal involvement in pediatric Henoch-Schönlein purpura: a French retrospective study", Arch Pediatr, 23, pp.584~590 (2016)
  17. Başaran Ö, "Plasma exchange therapy for severe gastrointestinal involvement of Henoch Schönlein purpura in children", Clin Exp Rheumatol, 33, pp.S176~S180 (2015)
  18. Mills JA, "The american college of rheumatology 1990 criteria for the classification of Henoch- Schönlein purpura", Arthritis Rheum, 33, pp.1114~1121 (1990)
  19. Saulsbury FT, "Henoch-Schönlein purpura in children. Report of 100 patients and review of the literature", Medicine (Baltimore), 78, pp.395~409 (1999)
  20. Jauhola O, "Clinical course of extrarenal symptoms in Henoch-Schönlein purpura: a 6-month prospective study", Arch Dis Child, 95, pp.871~876 (2010)
  21. Weiss PF, "Corticosteroids may improve clinical outcomes during hospitalization for Henoch-Schönlein purpura", Pediatrics, 126, pp.674~681 (2010)
  22. Masarweh K, "Establishing hospital admission criteria of pediatric Henoch-Schonlein purpura", Rheumatol Int, 34, pp.1497~1503 (2014)
  23. 최선미, "Henoch-Schonlein 자반증의 임상 역학적 연구(1987-2003년)", Korean Journal of Pediatrics, 48(2), pp.174~177 (2005), 대한소아과학회
  24. Zhao YL, "Obesity increases the risk of renal involvement in children with Henoch-Schönlein purpura", Eur J Pediatr, 174, pp.1357~1363 (2015)
  25. Anil M, "Henoch-Schönlein purpura in children from western Turkey: a retrospective analysis of 430 cases", Turk J Pediatr, 51, pp.429~436 (2009)
  26. 강윤, "Differences in Clinical Manifestations and Outcomes between Adult and Child Patients with Henoch-Schönlein Purpura", Journal of Korean Medical Science, 29(2), pp.198~203 (2014), 대한의학회
  27. 홍지나, "Laboratory Markers Indicating Gastrointestinal Involvement of Henoch-Schönlein Purpura in Children", Pediatric Gastroenterology, Hepatology & Nutrition, 18(1), pp.39~47 (2015), 대한소아소화기영양학회
  28. Nagamori T, "Construction of a scoring system for predicting the risk of severe gastrointestinal involvement in Henoch- Schönlein purpura", Springerplus, 3, pp.171~ (2014)
  29. Sano H, "Risk factors of renal involvement and significant proteinuria in Henoch-Schönlein purpura", Eur J Pediatr, 161, pp.196~201 (2002)
  30. 최현진, "소아 Henoch-Schonlein 신염의 예후 인자", Childhood Kidney Diseases, 9(2), pp.183~192 (2005), 대한소아신장학회
  31. Tabel Y, "Clinical features of children with Henoch-Schonlein purpura: risk factors associated with renal involvement", Iran J Kidney Dis, 6, pp.269~274 (2012)
  32. Wang X, "Henoch-Schönlein purpura with joint involvement: analysis of 71 cases", Pediatr Rheumatol Online J, 14, pp.20~ (2016)
  33. 김성우, "Henoch-Schonlein Purpura 환아에서 복통의 유무에 따른임상양상과 예후의 차이", Pediatric Gastroenterology, Hepatology & Nutrition, 14(4), pp.359~367 (2011), 대한소아소화기영양학회
  34. Nam EJ, "Gastrointestinal bleeding in adult patients with Henoch-Schönlein purpura", Endoscopy, 46, pp.981~986 (2014)
  35. Esaki M, "GI involvement in Henoch- Schönlein purpura", Gastrointest Endosc, 56, pp.920~923 (2002)
  36. 박선희, "내시경상 십이지장을 침범한 Henoch-Schönlein Purpura 환아의 임상적 특징", Pediatric Gastroenterology, Hepatology & Nutrition, 12(2), pp.156~162 (2009), 대한소아소화기영양학회
  37. Dudley J, "Randomised, double-blind, placebo- controlled trial to determine whether steroids reduce the incidence and severity of nephropathy in Henoch-Schonlein purpura (HSP)", Arch Dis Child, 98, pp.756~763 (2013)
  38. Shin JI, "Intravenous dexamethasone followed by oral prednisolone versus oral prednisolone in the treatment of childhood Henoch- Schönlein purpura", Rheumatol Int, 31, pp.1429~1432 (2011)
  39. Deng F, "Henoch-Schönlein purpura in childhood: treatment and prognosis. Analysis of 425 cases over a 5-year period", Clin Rheumatol, 29, pp.369~374 (2010)
  40. Jauhola O, "Outcome of Henoch-Schönlein purpura 8 years after treatment with a placebo or prednisone at disease onset", Pediatr Nephrol, 27, pp.933~939 (2012)

관련 논문AI추천

Henoch-Schonlein Purpura 환아에서 복통의 유무에 따른임상양상과 예후의 차이김성우, 윤정원, 정수진대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2011 · 제14권 제4호A Patient with Henoch-Schönlein Purpura with Intussusception and intractable NephritisHyun Ee Yim, Jeong Hong, Ki Soo Pai, Min Kyoung Seo대한소아신장학회 · Childhood Kidney Diseases2016 · 제20권 제2호소아 Henoch-Schönlein purpura에서 스테로이드 치료 기간에 따른 임상적 결과의 비교김기혁, 신재일, 이수진, 이종국대한소아신장학회 · Childhood Kidney Diseases2008 · 제12권 제2호Henoch-Sch nlein 자반증에서 스테로이드 사용이 신장 침범에 미치는 영향하태선, 홍은정대한소아신장학회 · Childhood Kidney Diseases2007 · 제11권 제2호Treatment of Severe Henoch-Schoenlein Purpura Nephritis in Children신재일, 이재승대한소아신장학회 · Childhood Kidney Diseases2010 · 제14권 제1호소아 Henoch-Schnlein Purpura 환아에서 위장관 증상 유무에 따른 임상 소견에 대한 연구김용주, 오세웅, 최재형대한소아소화기영양학회 · Pediatric Gastroenterology, Hepatology & Nutrition2006 · 제9권 제2호

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