title: Henoch-Schönlein purpura: recurrence and chronicity.
abstract: OBJECTIVE
  To describe a group of patients treated at our service for Henoch-Schönlein purpura, with emphasis on recurrent and chronic cases, and to compare clinical and demographic characteristics of patients with monocyclic and recurrent disease.
  
  
  METHODS
  Data on 67 patients who had been treated since disease onset were analyzed. Twelve patients were excluded because they failed to return for follow-up consultations after less than 3 months, leaving a total of 55 children in the study sample. Recurrence was defined as the presence of a fresh episode after a period of at least 3 months without symptoms, and cases were defined as chronic when cutaneous, abdominal and renal manifestations persisted for a period of 12 months or more.
  
  
  RESULTS
  Recurrence was observed in 8/55 patients (14.4%) and four cases were chronic (7.2%). In 29/55 patients (52.7%), infection was identified as the trigger factor. A monocyclic clinical course was observed in 43 patients (26 of whom were girls, with a mean age of 5.4 years). Gastrointestinal and renal involvement was observed in 55.8 and 20.9% of patients, respectively. Among the 12 patients with recurrent or chronic Henoch-Schönlein purpura, three had arthritis, four exhibited signs and symptoms of abdominal involvement and seven of kidney disease: microscopic hematuria in five, macroscopic hematuria in one and hematuria with proteinuria in one other. Late onset was the only variable related to recurrence (p < 0.05).
  
  
  CONCLUSIONS
  As is observed in medical literature, monocyclic cases are more common among children with early onset disease. Patients with Henoch-Schönlein purpura should be followed over the long term, since recurrent and chronic cases account for more than 20% of the total.
authors.affiliation: Departamento de Pediatria, Universidade Federal de São Paulo - Escola Paulista de Medicina, São Paulo, SP, Brazil.
authors.forename: Camila S
authors.initials: CS
authors.lastname: Alfredo
authors.forename: Nicole A
authors.initials: NA
authors.lastname: Nunes
authors.forename: Cláudio A
authors.initials: CA
authors.lastname: Len
authors.forename: Cássia M P
authors.initials: CM
authors.lastname: Barbosa
authors.forename: Maria Teresa R A
authors.initials: MT
authors.lastname: Terreri
authors.forename: Maria Odete E
authors.initials: MO
authors.lastname: Hilário
mesh_terms: D017668:Age of Onset; D001938:Brazil / Q000453:epidemiology; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D005921:Glomerulonephritis / Q000175:diagnosis; D006801:Humans; D011695:IgA Vasculitis / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D012189:Retrospective Studies; D055502:Secondary Prevention