Differences in Clinical Manifestations and Outcomes between Adult and Child Patients with Henoch-Schönlein Purpura
Open Access
- 1 January 2014
- journal article
- Published by Korean Academy of Medical Sciences in Journal of Korean Medical Science
- Vol. 29 (2), 198-203
- https://doi.org/10.3346/jkms.2014.29.2.198
Abstract
We aimed to investigate differences in clinical manifestations and outcomes between adult and child patients with Henoch-Schönlein purpura (HSP), and to analyze the factors associated with poor prognosis for HSP nephritis. This retrospective 10-yr study enrolled 160 patients with HSP who visited Severance Hospital. Purpura was mostly detected in lower extremities, but purpura in upper extremities was more frequently observed in adults than children (41.7% vs 19.3%). Children had a greater frequency of arthralgia (55.4% vs 27.1%), while adults had a greater frequency of diarrhea (20% vs 1.6%). Anemia, elevated C-reactive protein, and level of IgA were more frequently observed in adults (25% vs 7.1%, 65.6% vs 38.4%, 26.3% vs 3.5%). Renal involvement in adults was more severe than in children (79.2% vs 30.4%). Chronic renal failure showed a significant difference in outcomes of HSP between adults (10.4%) and children (1.8%) after a follow up period of an average of 27 months. Furthermore, renal insufficiency at diagnosis was significantly related to the progression to chronic renal failure. Our results showed several differences in the clinical features of HSP between adults and children. Adults with HSP had a higher frequency of renal insufficiency and worse renal outcomes than children. Renal insufficiency at diagnosis might be of predictive value for the progression to chronic renal failure in HSP patients.Keywords
This publication has 31 references indexed in Scilit:
- EULAR/PRINTO/PRES criteria for Henoch-Schonlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteriaAnnals Of The Rheumatic Diseases, 2010
- Clinical Manifestations of Korean Adult Patients with Henoch-Schönlein PurpuraThe Journal of the Korean Rheumatism Association, 2010
- Clinical Manifestations and Outcomes of Henoch-Schönlein Purpura: Comparison between Adults and ChildrenPediatrics & Neonatology, 2009
- A clinical study of Henoch‐Schönlein Purpura associated with malignancyJournal of the European Academy of Dermatology and Venereology, 2009
- Predictive factors for nephritis, relapse, and significant proteinuria in childhood Henoch–Schönlein purpuraScandinavian Journal of Rheumatology, 2006
- Henoch-Schönlein purpura associated with clarithromycin. Case report and review of literature clarithromycin. Case report and review of literatureInt. Journal of Clinical Pharmacology and Therapeutics, 2003
- Henoch-Schonlein purpura nephritisInternational Journal of Dermatology, 2003
- Henoch-Schoenlein nephritis in adults – clinical features and outcomes in Finnish patientsClinical Nephrology, 2002
- Henoch‐Schönlein purpura in adulthood and childhood. Two different expressions of the same syndromeArthritis & Rheumatism, 1997
- SCHÖNLEIN-HENOCH PURPURA IN ADULTSThe Lancet, 1971