title: Henoch Schonlein purpura in childhood: clinical analysis of 254 cases over a 3-year period.
abstract: We aimed to evaluate the patients who were diagnosed as Henoch Schonlein purpura (HSP) for disease characteristics and prognosis of those with joint, gastrointestinal (GI), and renal involvement. Two hundred and fifty-four children who were followed up with the diagnosis of HSP in the Pediatric Nephrology Clinics of Meram Medical Faculty of Selcuk University and Medical Faculty of Gazi University between January 2003 and June 2006 were retrospectively evaluated. The clinical follow-up and treatment regimens of patients in whom renal biopsy was performed were evaluated in detail. The study group consisted of 254 children, 147 boys (57.8%) and 107 girls (42.2%), and the ratio of boys to girls was 1.37. The percentages of skin, joint, GI, and renal manifestations were 100%, 66%, 56%, and 30%, respectively. Eight patients had intussusception. Five of them recovered with steroid treatment only while three patients were operated on. Sixty-four patients (44%) with GI involvement had severe disease and were successfully treated with steroids. Renal biopsy was performed in 26 patients. Among those 26 patients, two of them recovered spontaneously within 3 and 4 weeks. Ten patients improved with only steroid treatment while 12 patients recovered with steroid and cyclophosphamide treatment. Two patients were resistant to steroid and cyclophosphamide treatment and were treated with cyclosporine A. We believe that steroid therapy given to the HSP patients with GI manifestations might be helpful to prevent probable complications such as GI bleeding and intussusception. In addition, combined therapy with steroid and cyclophosphamide can usually be an appropriate treatment for patients with nephrotic proteinuria.
authors.affiliation: Department of Pediatric Nephrology, Medical Faculty, Gazi University, Besevler, Ankara, Turkey. peruharun@yahoo.com
authors.forename: Harun
authors.initials: H
authors.lastname: Peru
authors.forename: Oguz
authors.initials: O
authors.lastname: Soylemezoglu
authors.forename: Sevcan Azime
authors.initials: SA
authors.lastname: Bakkaloglu
authors.forename: Sefika
authors.initials: S
authors.lastname: Elmas
authors.forename: Davut
authors.initials: D
authors.lastname: Bozkaya
authors.forename: Ahmet Midhat
authors.initials: AM
authors.lastname: Elmaci
authors.forename: Fatih
authors.initials: F
authors.lastname: Kara
authors.forename: Necla
authors.initials: N
authors.lastname: Buyan
authors.forename: Enver
authors.initials: E
authors.lastname: Hasanoglu
mesh_terms: D002648:Child; D002675:Child, Preschool; D016572:Cyclosporine / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D005767:Gastrointestinal Diseases / Q000150:complications; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications / Q000628:therapy; D007443:Intussusception / Q000150:complications; D007592:Joint Diseases / Q000150:complications; D007674:Kidney Diseases / Q000150:complications; D008297:Male
chemical_list: D016572:Cyclosporine