[Henoch-Schönlein purpura - one of the most common types of systemic vasculitis in childhood].
The aim of our study was to estimate etiology, most common clinical findings, the course and peculiarities of treatment in children to whom Henoch-Schönlein purpura was diagnosed during 1996-2002 at Clinic of Children's Diseases of Kaunas University of Medicine Hospital.


METHODS
The Henoch-Schönlein purpura diagnosis was based on the association of non-trombocytopenic purpura, arthritis and abdominal pain in 45 children, mostly at preschool age. Routine laboratory blood tests usually were normal. Serum level of imunoglobulin A (Ig A), complement 3, 4 (C(3), C(4)), antineutrophil cytoplasm antibodies were measured for some patients. Urinary analyses were performed for all patients in order to assess nephritis.


RESULTS
In 1/3 (33.3%) of children Henoch-Schönlein purpura was preceded by an upper respiratory tract infection. The most common clinical signs were: non-trombocytopenic purpura -100%, subcutaneous edema - 53%, arthritis of large joints - 64%, gastrointestinal symptoms (pain, diarrhea with bleeding) - 37.5%. The incidence of renal involvement was 13.3%, but usually not at the onset of the disease. Relapses were often, and they had tendency to repeat in 1-2 week periods. Late relapses were absent. Treatment of Henoch-Schönlein purpura was symptomic. Nonsteroidal anti-inflammatory drugs which are helpful in joint pain, were prescribed for 33.3% patients. Steroids which reduce abdominal pain, melena, massive hemorrhage, nephritic symptoms, were given for 28.8% patients.


CONCLUSIONS
Non-trombocytopenic purpura, arthritis and colic abdominal pain, classic triad of Henoch-Schönlein purpura that occurs in early stage of the disease, were most common. Renal involvement had tendency occur later. Nonsteroidal anti-inflammatory drugs were prescribed for patients with arthritis; prednisone reduced gastrointestinal, nephritic symptoms. Relapses were often.
Sileikiene
Rima
R
Clinic of Children's Diseases, Kaunas University of Medicine Hospital, Lithuania. childdgn@ kma.lt
Tamakauskiene
Edita
E
Baksiene
Dalia
D
D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000367:Age Factors; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003176:Complement C3 / Q000032:analysis; D003181:Complement C4 / Q000032:analysis; D005260:Female; D006801:Humans; D011695:IgA Vasculitis / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D007070:Immunoglobulin A / Q000032:analysis; D007223:Infant; D008297:Male; D011239:Prednisolone / Q000627:therapeutic use; D012008:Recurrence; D013997:Time Factors
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D000894:Anti-Inflammatory Agents, Non-Steroidal; D019268:Antibodies, Antineutrophil Cytoplasmic; D003176:Complement C3; D003181:Complement C4; D007070:Immunoglobulin A; D011239:Prednisolone