Fifteen-year experience of children with Henoch-Schönlein purpura in southern Taiwan, 1991-2005.
OBJECTIVE
Although Henoch-Schönlein purpura (HSP) is the most common cause of systemic vasculitis in children, long-term and large-scale Taiwanese studies on HSP are rare. We reviewed the records of 107 Taiwanese pediatric patients diagnosed with HSP at our institution between 1991 and 2005.


METHODS
The first clinical manifestations, laboratory findings, and outcome evaluations of the patients were analyzed. Data were grouped according to the presence of fever and upper respiratory tact infection (URI) as a presenting symptom and also by gender. Chi-squared test was used for statistical analysis.


RESULTS
The children had a mean age of 6.2 +/- 2.5 years (range, 2 to 13 years), with a male-to-female ratio of 1.0:0.7. Main clinical symptoms included skin rashes (95.3%), gastrointestinal (GI) symptoms (72.0%), joint involvement (46.7%), and kidney involvement (28.0%). The most common first manifestations were skin rashes (56.1%), GI symptoms (35.5%), and joint involvement (12.1%). There was no significant association between first manifestations and fever presence or gender. However, the non-URI patients had a significantly higher incidence of GI problems than the URI group (p=0.01). Fever as a symptom was not associated with elevation of C-reactive protein (p=0.45). Immunoglobulin A levels were within the normal range. No chronic renal failure or end-stage renal disease was detected, and overall the prognosis of patients was good.


CONCLUSIONS
The categories used did not predict the expression of HSP, with the exception of an association between absence of URI and GI manifestations. Overall, HSP showed a good prognosis.
Nong
Bao-Ren
BR
Department of Pediatrics, Veterans General Hospital-Kaohsiung, Kaohsiung, Taiwan. brnong@yahoo.com.tw
Huang
Yung-Feng
YF
Chuang
Chih-Ming
CM
Liu
Chia-Chia
CC
Hsieh
Kai-Sheng
KS
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology; D006417:Hematuria / Q000209:etiology; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D008297:Male; D009393:Nephritis / Q000209:etiology; D011379:Prognosis; D011507:Proteinuria / Q000209:etiology; D012141:Respiratory Tract Infections / Q000150:complications; D012737:Sex Factors; D013624:Taiwan