title: Differences in clinical manifestations and outcomes between adult and child patients with Henoch-Schönlein purpura.
abstract: We aimed to investigate differences in clinical manifestations and outcomes between adult and child patients with Henoch-Schönlein purpura (HSP), and to analyze the factors associated with poor prognosis for HSP nephritis. This retrospective 10-yr study enrolled 160 patients with HSP who visited Severance Hospital. Purpura was mostly detected in lower extremities, but purpura in upper extremities was more frequently observed in adults than children (41.7% vs 19.3%). Children had a greater frequency of arthralgia (55.4% vs 27.1%), while adults had a greater frequency of diarrhea (20% vs 1.6%). Anemia, elevated C-reactive protein, and level of IgA were more frequently observed in adults (25% vs 7.1%, 65.6% vs 38.4%, 26.3% vs 3.5%). Renal involvement in adults was more severe than in children (79.2% vs 30.4%). Chronic renal failure showed a significant difference in outcomes of HSP between adults (10.4%) and children (1.8%) after a follow up period of an average of 27 months. Furthermore, renal insufficiency at diagnosis was significantly related to the progression to chronic renal failure. Our results showed several differences in the clinical features of HSP between adults and children. Adults with HSP had a higher frequency of renal insufficiency and worse renal outcomes than children. Renal insufficiency at diagnosis might be of predictive value for the progression to chronic renal failure in HSP patients.
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yoon
authors.initials: Y
authors.lastname: Kang
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Jin-su
authors.identifier: 0000-0003-4228-3750
authors.initials: JS
authors.lastname: Park
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: You-Jung
authors.initials: YJ
authors.lastname: Ha
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Mi-il
authors.initials: MI
authors.lastname: Kang
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Hee-Jin
authors.initials: HJ
authors.lastname: Park
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Sang-Won
authors.initials: SW
authors.lastname: Lee
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Soo-Kon
authors.initials: SK
authors.lastname: Lee
authors.affiliation: Division of Rheumatology, Department of Internal Medicine, Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea.
authors.forename: Yong-Beom
authors.identifier: 0000-0003-4695-8620
authors.initials: YB
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018771:Arthralgia / Q000453:epidemiology / Q000209:etiology; D002097:C-Reactive Protein / Q000032:analysis; D002648:Child; D002675:Child, Preschool; D003967:Diarrhea / Q000453:epidemiology / Q000209:etiology; D005121:Extremities / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D011695:IgA Vasculitis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology*; D007070:Immunoglobulin A / Q000097:blood; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D007223:Infant; D008875:Middle Aged; D016017:Odds Ratio; D011379:Prognosis; D051437:Renal Insufficiency / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D007070:Immunoglobulin A; D007166:Immunosuppressive Agents; D002097:C-Reactive Protein
keywords: Adult; Child; Outcome; Prognostic Factor; Purpura, Henoch-Schönlein