Clinical characteristics of children henoch-schönlein purpura: Report of 91 cases
10.16781/j.0258-879x.2018.05.0504
- Author:
Lei LEI
1
Author Information
1. Department of Pediatrics, Changhai Hospital, Navy Medical University (Second Military Medical University)
- Publication Type:Journal Article
- Keywords:
Child;
Clinical manifestation;
Henoch-Schönlein purpura;
Immune function;
Renal damage
- From:
Academic Journal of Second Military Medical University
2018;39(5):505-509
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the clinical characteristics and incidence of children Henoch-Schonlein purpura (HSP). Methods We retrospectively analyzed the clinical and laboratory characteristics of children with HSP in our hospital between Jun. 2012 and Jul. 2014, and compared the results with Hunan province, plateau area of Tibet, and Wuhan city in China and Indonesia. Eighty-seven healthy children, who received physical examination in our hospital during the same period, were recruited as healthy control group. The immune functions were compared between the HSP patients (skin involvement, non-renal damage and renal damage) and healthy children. Results The ratio of male to female was 1.07.1 in the 91 HSP patients aged (8.3±2.4) years old. The age of >5 and ≤10 years old had the peak morbidity, and the morbidity time concentrated between October and December. The main cause of HSP was respiratory tract infection, and 34 cases (37.36%)had a history of respiratory tract infection within 2 weeks before onset. In clinical manifestations, 80 cases (88.89%) had rash and 12 (13.19%) had renal involvement at the first stage. During the whole course of disease, all 91 (100.00%) children suffered from rash, and 34 (37.36%) children had renal involvement. The incidence of renal involvement was significantly lower versus the incidence in Hunan province (χ2=19.194, P<0.01), and was significantly higher versus the incidence in plateau area of Tibet and Wuhan city (χ2=3.591, 12.319; both P<0.05). The incidence of renal involvement was significantly higher in the children aged >10 and ≤15 years than that in the children aged >5 and ≤10, and >1 and ≤5 years (χ2=5.570, 4.077; both P<0.05). The mean onset time of accompanying symptoms was on about 7 days, and the latest symptom was abnormality of renal function, with an average of about 10 d. In immunologic function, the proportion of CD4+ T lymphocytes and the ratio of CD4+ to CD8+ T lymphocytes were significantly lower in the HSP group than those in the healthy control group (t=8.460, 9.460; both P<0.01), while no significant differences were found between the skin, non-renal damage or renal damage groups. The levels of IgG, IgA and IgE were significantly higher in the HSP group than those in the healthy control group (t=7.841, 13.933, 6.870; all P=0.01). The levels of IgG and IgA were significantly higher in the renal damage group than those in the skin group (t=4.941, 5.111; both P=0.01). Conclusion Occult infection should be emphasized in the incidence of HSP. Renal involvement is always imperceptible, and long time dynamic monitoring of urine routine is very important at early stage of HSP. The imbalance of immunologic function plays an important role in the HSP, especially in the reducing ratio of CD4+ to CD8+ T lymphocytes, but has no correlation with the severity of the disease.
