This study aimed to evaluate renal involvement and factors affecting the prognosis in patients with Henoch-Schonlein purpura (HSP).
The outcomes of 107 children diagnosed with HSP who had been followed up for at least 6 months were reviewed.
Renal involvement was observed in 26.1% of the patients. The mean age of the patients with renal involvement was 8.8 ± 4.0 years as compared to 7.1 ± 2.9 years in the patients without renal involvement (P = .02). The risk of renal involvement was found to be significantly higher in the patients who were 10 years old and over (P < .001). In the group with renal involvement, the frequency of scrotal involvement was significantly higher than that of the group without renal involvement (P = .02). The mean serum immunoglobulin A level of the patients with renal involvements was significantly higher (P = .04) and the mean serum complement C3 levels was significantly lower (P = .04) than those of the patients without renal involvement. None of the patients with renal involvement reached end-stage kidney failure. No significant relationship was observed between the development of renal involvement and early steroid treatment.
This study proposes that in old children with HSP, elevated serum immunoglobulin A levels, decreased serum complement C3 levels, and scrotal involvement are associated with renal involvement. We failed to find any effect of steroid treatment on development of renal involvement.
[Show abstract][Hide abstract] ABSTRACT: Purpose of review:
To review the current knowledge of epidemiological features of immunoglobulin (Ig) A vasculitis (Henoch-Schönlein) and disease etiology.
The annual incidence of IgA vasculitis in the population is an estimated 3-26.7/100 000 for children and infants and 0.8-1.8/100 000 for adults. These may be conservative approximations of the true frequency because of skewed case-finding strategies. In children, the marked autumn-winter peak in incidence rates, the frequent occurrence after an upper respiratory tract infection and the short interval between disease onset in index cases and in other family members collectively point to a transmissible infectious process. A subset of adult IgA vasculitis could be related to preceding or concurrent malignancies. Despite several lines of evidence supporting the critical role of an exogenous factor in IgA vasculitis, recent progress has been made in understanding the genetic susceptibility to IgA vasculitis. Recent findings also lessened the suggestion that IgA vasculitis might be triggered by vaccination.
IgA vasculitis is two to 33 times more common in children than adults and appears to have a strong environmental component, with possibly different risk factors in childhood and adulthood. Support is strengthening for a role of genetics in IgA vasculitis.
Current opinion in rheumatology 01/2013; 25(2). DOI:10.1097/BOR.0b013e32835d8e2a · 4.89 Impact Factor
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