ESPN 51th Annual Meeting

ESPN 2018


 
HENOCH–SCHÖNLEIN PURPURA: CLINICAL COURSE AND EVALUATION OF PREDICTIVE FACTORS FOR THE SYSTEM INVOLVEMENT
UNAL AKCA 1 OZAN OZKAYA 2 HULYA NALCACIOGLU 3 GULFER AKCA 1 GURKAN GENC 3

1- ONDOKUZ MAYIS UNIVERSITY FACULTY OF MEDICINE, DEPARTMENT OF PEDIATRICS, SAMSUN, TURKEY
2- ONDOKUZ MAYIS UNIVERSITY FACULTY OF MEDICINE, PEDIATRIC NEPHROLOGY AND RHEUMATOLOGY DEPARTMENT, SAMSUN, TURKEY
3- ONDOKUZ MAYIS UNIVERSITY FACULTY OF MEDICINE, PEDIATRIC NEPHROLOGY DEPARTMENT, SAMSUN, TURKEY
 
Introduction:

 The aim of our study was to evaluate the demographic, clinical and prognostic features of the Henoch Schönlein purpura (HSP) patients and to search for the risk factors of the system involvemet. 

Material and methods:

 In this retrospective study, 364 HSP patients were evaluated. The diagnosis of HSP was made according to the criteria of ACR between 2005 and 2008, and the criteria of EULAR after 2008. Renal biopsy was performed in patients with acute kidney injury or/and nephrotic range proteinuria. 

Results:

364 patients (56.3% male) with a mean age of 8.32 ± 3.38 years were included. Of the 364 patients, 57.1% had joint involvement, 50.8% gastrointestinal system (GIS), 29.7% renal involvement, 1.3% scrotal and 0.8% central nervous system involvement. The mean erythrocyte sedimentation rate was 22.2 ± 18.2 mm / hr and the mean CRP was 16.7 ± 32.1 mg / L. Of the 108 patients with renal involvemet 12% of patients had isolated microscopic hematuria, 6.5% macroscopic hematuria, 60.2% mild (non-nephrotic) proteinuria, 7.4% nephritic syndrome, 6.5% nephrotic syndrome and 7.4% nephritic-nephrotic syndrome. Thirteen patients underwent renal biopsy. Pathological staging was stage I: 7%, stage II: 47%, stage III: 47% and none of our cases developed end-stage renal failure. Logistic regression analysis showed that age and thrombocytosis were risk factors for renal involvement (OR = 1.61, p = 0.004, CI = 1.16-2.23 / OR = 2.21, p = 0.02, 33 -3.65 respectively) and leukocytosis was also a risk factor for gastrointestinal involvement (OR = 4,41, p = 0,001, CI = 2,32-8,36). Of the 4.1% of patients had also FMF. The most common genotype was M694V homozygous.

Conclusions:

In our study, renal involvement was present in 29.7 % of patients. Age and thrombocytosis were found to be risk factors for renal involvement whereas leukocytosis was a risk factor for GIS involvement. Taking a detailed history of FMF in HSP patients will lead to earlier diagnosis of FMF because of the increased frequency of FMF in patients with HSP.