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Predictive factor of severe renal involvement in children with Henoch-Schoenlein purpura
Wanida Limpongsanurak1, Chookiet Kietkajornkul, Srisupalak Singalavanija
1Dermatology Unit, Department of Pediatrics, Queen Sirikit National Institute of Child Health, College of Medicine, Rangsit University Bangkok, Thailand. limpong7@hotmail.com
Insights
Abnormal urinalysis in children with Henoch-Schonlein purpura (HSP) predicts severe kidney involvement. Early steroid treatment for abdominal pain did not prevent this complication.
Area of Science:
- Pediatrics
- Nephrology
- Rheumatology
Background:
- Henoch-Schonlein purpura (HSP) is a common childhood vasculitis.
- Renal involvement is a significant complication of HSP, potentially leading to severe kidney disease.
- Identifying early predictors of severe renal involvement is crucial for timely intervention.
Purpose of the Study:
- To determine clinical and laboratory predictors of severe renal involvement in pediatric HSP.
- To evaluate the efficacy of early systemic corticosteroid administration in preventing severe renal complications.
Main Methods:
- Prospective data collection of clinical manifestations and laboratory findings in children diagnosed with HSP.
- Analysis of 168 pediatric cases over a 5-year period (2003-2007).
- Statistical analysis to identify significant predictive factors for severe renal involvement.
Main Results:
- Abnormal urinalysis (microscopic hematuria or proteinuria) at diagnosis was a highly significant predictor (p < 0.001) of severe renal involvement.
- Severe renal involvement was observed in 6.6% of the studied pediatric population.
- Early systemic corticosteroid treatment for severe abdominal pain did not show a statistically significant difference in preventing severe renal involvement.
Conclusions:
- Abnormal urinalysis on the day of diagnosis is the sole identified predictive factor for severe renal involvement in pediatric HSP.
- Early corticosteroid therapy for abdominal pain does not appear to prevent the development of severe kidney complications in HSP.
- Urinalysis serves as a vital tool for risk stratification in children with Henoch-Schonlein purpura.
Objective:
To find out which of the clinical manifestations or laboratory findings is the predictive factor of severe renal involvement in children with Henoch-Schoenlein purpura (HSP).
Material And Method:
Data of clinical manifestations and laboratory findings in children with HSP at Queen Sirikit National Institute of Child Health between January 2003-December 2007 were prospectively collected and analyzed.
Results:
There were 168 cases, 86 boys and 82 girls (M:F ratio= 1.05:1), the age ranged from 2 to 15 years (mean +/- SD = 6.9 +/- 2.6 years, mode = 6.8 years). Development of severe renal involvement was identified in 11 cases (6.6%). Abnormal urinalysis (microscopic hematuria or proteinuria) on the day of diagnosis was statistically significant (p < 0.001) as a predictive factor of severe renal involvement during follow-up. Early systemic corticosteroid administration due to severe abdominal pain was not statistically significantly different between the patients with or without severe renal involvement.
Conclusion:
Abnormal urinalysis on the day of diagnosis was the only predictive factor of severe renal involvement in children with Henoch-Schoenlein purpura. Early systemic corticosteroid administration due to severe abdominal pain did not prevent severe renal involvement.
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