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A five year review of clinical profile in HSP
N Grover1, N Sankhyan, J P Bisht
1Dept. of Pediatrics, Indira Gandhi Medical College, Shimla, Himachal Pradesh, India. drngrover@rediffmail.com
Insights
Henoch-Schönlein Purpura (HSP) commonly affects children, primarily involving skin, joints, and the gastrointestinal tract. Early recognition of classic symptoms is key, though atypical presentations can cause diagnostic challenges.
Area of Science:
- Pediatrics
- Rheumatology
- Nephrology
Background:
- Henoch-Schönlein Purpura (HSP) is a common vasculitis affecting small blood vessels.
- Understanding its clinical profile in children is crucial for timely diagnosis and management.
Observation:
- A retrospective case series reviewed 30 children diagnosed with HSP.
- Focus was placed on clinical manifestations, including skin, joint, gastrointestinal (GIT), and renal involvement.
- Two cases with unusual features were detailed.
Findings:
- All patients (100%) exhibited skin involvement, predominantly palpable purpura.
- Joint (86.7%), GIT (80%), and renal (30%) systems were also frequently affected.
- Abdominal pain and arthritis (knee/ankle) were common; atypical presentations like vesciculobullous lesions occurred.
Implications:
- Most children present with classical HSP manifestations.
- Atypical or absent cutaneous features at onset can lead to diagnostic confusion.
- Awareness of diverse clinical profiles aids in accurate pediatric HSP diagnosis.
Abstract:
To study the clinical profile of Henoch Schönlein Purpura [HSP] in children. A retrospective case series of 30 consecutive children with a diagnosis of HSP, with special focus on clinical manifestations. Two cases with unusual features are described in detail. Data of 19 boys and 11 girls with a mean age of 10.55 years was reviewed. Overall skin was involved in 100%, joints in 86.7%, GIT in 80% and renal system in 30% Two-thirds had palpable purpura at presentation. The mean duration of appearance of skin lesions after preceding joint and gastrointestinal symptoms was 8.6 days and 6.6 days respectively. Abdominal pain was the most common gastrointestinal symptom. Knee and ankle involvement occurred in more than 3/4th of the patients with arthritis. Vesciculobullous lesions were seen in two patients while one patient had rheumatic fever. Most children with HSP will have classical manifestation of the disease but diagnostic confusion can occur in those with atypical or absent cutaneous features at the onset.
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