title: Henoch Schonlein purpura in childhood: epidemiological and clinical analysis of 150 cases over a 5-year period and review of literature.
abstract: OBJECTIVE
  To examine epidemiological, clinical, and outcome in Italian children affected with Henoch Schönlein purpura (HSP).
  
  
  METHODS
  Retrospective study of children discharged with a diagnosis of HSP from the Meyer Children's Hospital, between 1998 and 2002. Epidemiological, clinical, laboratory data, treatment, and outcome were collected by reviewing medical charts. One year after data collection, the children's parents were interviewed by telephone about the outcome.
  
  
  RESULTS
  150 children entered the study: M:F=1.8:1; mean age 6.1+/-2.7 years. At onset, purpura was present in all cases, arthritis/arthralgias in 74%, abdominal involvement in 51%, scrotal edema in 13%, renal involvement in 54%, severe nephropathy in 7%, acute renal insufficiency in 2%, and intussusception in 0.6%. Purpura was the presenting symptom in 74%, arthritis in 15%, and abdominal pain in 12%. The most frequent laboratory abnormalities were high-erythrocyte sedimentation rate (ESR) (57%), hyper-IgA (37%), and proteinuria (42%). All patients recovered within 2 months. Recurrences, verified in 35%, were correlated with high ESR values and corticosteroid (CS) treatment, independently from other variables. After a mean 2.5-years follow-up, 2 patients had hematuria with normal renal function.
  
  
  CONCLUSIONS
  Epidemiological and clinical findings in our cohort are similar to those in the literature, even though the mean disease duration was shorter than previously reported. Relapses occurred significantly more frequently in children treated with CS. This finding supports the recommendation to limit the use of steroids to a carefully selected group of HSP children. The prognosis was excellent; although severe nephropathy was found in a small percentage of the children, at follow-up all had normal renal function. Thus, our study confirms the benignity of HSP in Italian children, especially regarding renal outcome.
authors.affiliation: Department of Pediatrics, University of Florence, Anna Meyer Children's Hospital, Florence, Italy. sandra.trapani@unifi.it
authors.forename: Sandra
authors.initials: S
authors.lastname: Trapani
authors.forename: Annalisa
authors.initials: A
authors.lastname: Micheli
authors.forename: Francesca
authors.initials: F
authors.lastname: Grisolia
authors.forename: Massimo
authors.initials: M
authors.lastname: Resti
authors.forename: Elena
authors.initials: E
authors.lastname: Chiappini
authors.forename: Fernanda
authors.initials: F
authors.lastname: Falcini
authors.forename: Maurizio
authors.initials: M
authors.lastname: De Martino
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D011695:IgA Vasculitis / Q000188:drug therapy / Q000453:epidemiology*; D015994:Incidence; D007223:Infant; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D017678:Sex Distribution; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology
chemical_list: D005938:Glucocorticoids