title: Henoch-Schönlein purpura: a long-term prospective study in Greek children.
abstract: OBJECTIVE
  Henoch-Schönlein purpura is a common vasculitis of childhood. The present study, comprising 74 children enrolled during a 9-year period, aimed to delineate the clinical spectrum and the long term follow-up of the disease.
  
  
  METHODS
  Patients were diagnosed strictly on the criteria established by the American College of Rheumatology. The diagnosis was further strengthened by a skin biopsy performed in more than half of cases (42/74), which revealed leukocytoclastic vasculitis in all patients, whereas IgA deposits were found in 37/42 children.
  
  
  RESULTS
  There was a predominance of boys (41 males), and the mean age of study population was 5.2 +/- 2.54 years. Palpable purpura was identified in 73/74 children, whereas transient arthritis manifested in 68/74 children. Gastrointestinal blood loss was elicited in 30 children, 11 of whom had also renal involvement. The latter was seen in 19/74 (25.7%) children, and in the long term follow-up (extended to 2004, from 4-12 years, mean duration 7.3 years), 2 children remained with persistent occult hematuria. Relapses occurred in 49 children (66%), and half of them experienced more than 1 recurrence. Arthritis was less common in the relapsed episodes, and this difference was statistically significant (P < 0.001). Relapses tended to be more common in children with renal involvement and colicky abdominal pain without however reaching statistical significance.
  
  
  CONCLUSIONS
  Despite common relapses, this disease is benign in the long term even if severe renal involvement can occur during its active period. Recurrences often differ to some extent from the initial episode with arthritis being less common with relapses.
authors.affiliation: Department of Pediatrics, Athens University Medical School, Athens, Greece.
authors.forename: Andrew
authors.initials: A
authors.lastname: Fretzayas
authors.forename: Irini
authors.initials: I
authors.lastname: Sionti
authors.forename: Maria
authors.initials: M
authors.lastname: Moustaki
authors.forename: Anastasios
authors.initials: A
authors.lastname: Papadimitriou
authors.forename: Polyxeni
authors.initials: P
authors.lastname: Nicolaidou
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000367:Age Factors; D001706:Biopsy; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006115:Greece; D006801:Humans; D011695:IgA Vasculitis / Q000188:drug therapy* / Q000453:epidemiology / Q000503:physiopathology*; D007070:Immunoglobulin A / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D012621:Seasons; D012737:Sex Factors; D012867:Skin / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000305:Adrenal Cortex Hormones; D007070:Immunoglobulin A