Comparison of the Clinical Manifestations and Prognosis of Henoch-Schonlein Purpura in Children with and without Abdominal Pain.
10.5223/kjpgn.2011.14.4.359
- Author:
Sungwoo KIM
1
;
Jungwon YOON
;
Sujin JEONG
Author Information
1. Department of Pediatrics, CHA Bundang Medical Center, CHA University of Medicine, Seongnam, Korea. jinped@hanmail.net
- Publication Type:Original Article
- Keywords:
Henoch-Schonlein Purpura;
Ultrasonography;
Endoscopy;
Abdominal pain
- MeSH:
Abdominal Pain;
Child;
Duodenum;
Endoscopy;
Endoscopy, Gastrointestinal;
Humans;
Inpatients;
Length of Stay;
Occult Blood;
Prognosis;
Purpura;
Purpura, Schoenlein-Henoch;
Recurrence;
Retrospective Studies;
Stomach
- From:Korean Journal of Pediatric Gastroenterology and Nutrition
2011;14(4):359-367
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: We compared the clinical manifestations and prognosis of Henoch-Schonlein Purpura (HSP) in children with and without abdominal pain to investigate the usefulness of endoscopy. METHODS: We retrospectively studied 185 HSP inpatients (group A [with abdominal pain] and group N [without abdominal pain]) who had been admitted to the BundangCHA hospital between 2001 and 2010. We compared clinical manifestations, laboratory findings and endoscopic and ultrasonographic findings. RESULTS: Of the 185 children, 112 (60.5%) had abdominal pain and 31 (16.8%) presented with abdominal pain before developing cutaneous purpura. Group A patients were older (6.9+/-3.5 vs. 5.3+/-3.3 years), had higher rates of positive results for stool occult blood (53.8%, p<0.001), and had longer hospital stays (5.2+/-4.2 vs. 3.6+/-2.5 days) than group N patients. Group A had a higher frequency of renal involvement than group N on admission (p=0.047). Ultrasonography showed small bowel wall thickening in 31 cases (43.7%) and increased Doppler flow in the bowel wall in 22 cases (31%) in Group A. Upper gastrointestinal endoscopy revealed HSP - related lesions in the stomach (25 cases) and duodenum (19 cases). The second portion of the duodenum was a more common lesion site than the duodenal bulb. Ultrasonography showed abnormalities in 13 of 19 patients with duodenal lesions. Recurrence was more common in Group A. CONCLUSION: These results suggest that recurrence and renal involvement are more common in HSP patients with abdominal pain. Upper gastrointestinal endoscopy could be a useful diagnostic tool for HSP patients who develop abdominal pain before cutaneous purpura.
