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Henoch-Schonlein purpura in Thai children: a report from single center
Pimprae Pengpis1, Sukrawan Intrakao, Sookkasem Khositseth
1Department of Pediatrics, Faculty of Medicine, Thammasat University, Klongluang, Pathumthani, Thailand.
Insights
Henoch Schonlein Purpura (HSP) is a common childhood vasculitis. Colchicine showed promise in treating prolonged or recurrent HSP cases, particularly without kidney involvement, warranting further study.
Area of Science:
- Pediatrics
- Rheumatology
- Immunology
Background:
- Henoch Schonlein Purpura (HSP) is the most frequent vasculitis affecting children.
- Recurrences of HSP are common, and prolonged cases may require intervention.
- Colchicine, an anti-inflammatory agent, has limited documented use in severe pediatric HSP.
Purpose of the Study:
- To describe the epidemiology, clinical features, treatments, and outcomes of pediatric Henoch Schonlein Purpura patients.
- To evaluate the role of colchicine in managing prolonged or recurrent HSP.
Main Methods:
- Retrospective study of 26 pediatric patients diagnosed with HSP.
- Data collected from January 2004 to December 2010 at a single center in Thailand.
- Analysis of patient demographics, clinical manifestations, symptom duration, recurrences, and treatment responses.
Main Results:
- The mean age of patients was 7.2 years, with 57.7% being female.
- Common manifestations included skin (100%), joint (69.2%), gastrointestinal (50%), and renal (19.2%) involvement.
- Five patients (19%) experienced recurrences, and one patient achieved remission of severe petechiae with colchicine after dapsone-induced methemoglobinemia.
Conclusions:
- Pediatric HSP in this cohort had excellent outcomes without major complications.
- Colchicine may be effective for prolonged HSP, especially in cases without renal involvement.
- Further controlled studies are needed to confirm colchicine's efficacy and optimal dosage for HSP.
Abstract:
Henoch Schonlein Purpura (HSP) is the most common vasculitis in childhood. It is a self-limited disease. Recurrent HSP is not uncommon. Colchicine, an anti-inflammatory drug, has been used in prolonged HSP in only a few patients with good response. The present study described pediatric HSP patients in a single center, Thailand. To determine the epidemiology, clinical manifestations, treatments, and outcomes of HSP patients, the authors retrospectively studied 26 patients (age < 15 years) diagnosed with HSP at Thammasat University Hospital, from January 01, 2004 through December 31, 2010. The mean age was 7.2 +/- 3.8 years; median (range) follow-up was 2 (0.5-39) months. Fifteen (57.7%) patients were female. Clinical manifestations were skin (100%), joint (69.2%), gastrointestinal symptoms (50%) and renal involvement (19.2%). Symptoms lasted within 8 weeks in 21 (80%) patients. Recurrences identified in 5 (19%) patients with a mean of 4.8 +/- 2.4 times. The clinical outcome was excellent without major complication. Colchicine induced remission of severe and recurrent petechiae in one patient who developed methemoglobinemia after dapsone therapy. Colchicine may be an effective drug for prolonged HSP without renal involvement. The controlled studies to establish benefit effect and optimal regimen of colchicine in HSP is required.
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