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Pediatric vasculitis: a single center experience
Alexios Alexopoulos1, Maria Dakoutrou1, Kalliopi Stefanaki1
1First Department of Pediatrics, University of Athens, Aghia Sofia Children's Hospital, Athens, Greece.
Insights
Henoch-Schönlein purpura is the most common childhood vasculitis presenting with a rash. While most pediatric skin vasculitides have a good prognosis, urticarial vasculitis warrants thorough examination due to potential severe underlying disease.
Area of Science:
- Pediatric Rheumatology
- Dermatology
- Immunology
Background:
- Limited studies exist on childhood vasculitis.
- Vasculitic rash in children requires comprehensive epidemiological and clinical assessment.
Purpose of the Study:
- To evaluate the epidemiology, clinical features, laboratory findings, and outcomes of pediatric vasculitic rash in Greece.
- To identify the most prevalent types of childhood vasculitis and their characteristics.
Main Methods:
- Retrospective data collection from 2003-2013.
- Inclusion of children with a provisional diagnosis of skin vasculitis.
- Standardized data collection forms used for analysis.
Main Results:
- 95 children (mean age 5.9 years) were analyzed.
- Henoch-Schönlein purpura (HSP) was diagnosed in 80% of cases.
- Other diagnoses included hypersensitivity vasculitis (10.5%), urticarial vasculitis (6.3%), and acute hemorrhagic edema of infancy (3.1%).
Conclusions:
- Henoch-Schönlein purpura is the predominant form of childhood vasculitis with rash.
- Hypersensitivity vasculitis is more common in older children.
- Urticarial vasculitis may indicate severe disease, necessitating careful evaluation; overall prognosis is good except for urticarial vasculitis.
Background:
Existing studies of children with vasculitis are limited. The aim of this study was to assess the epidemiology, clinical manifestations, laboratory findings, course, and outcome of Greek children presenting with vasculitic rash.
Methods:
The relevant data included in the study were collected retrospectively using a standardized form from children who were admitted into our department between 2003 and 2013, with the provisional diagnosis of vasculitis of the skin.
Results:
The study sample consisted of 95 children (58 boys, 37 girls) with a mean age of 5.9 years. In total, 76 out of 95 (80%) of the children were diagnosed with Henoch-Schönlein purpura, 10/95 (10.5%) with hypersensitivity vasculitis, 6/95 (6.3%) with urticarial vasculitis, and 3/95 (3.1%) with acute hemorrhagic edema of infancy. The mean age of the children was 5.7 years for Henoch-Schönlein purpura, 9 years for hypersensitivity vasculitis, 5.1 years for urticarial vasculitis, and 0.5 years for acute hemorrhagic edema of infancy.
Conclusions:
(i) The most common vasculitis presenting with skin rash in children is Henoch-Schönlein purpura; (ii) hypersensitivity vasculitis occurs in older children more often when compared to other types of vasculitis; (iii) urticarial vasculitis lesions may be a sign of severe underlying disease; therefore a thorough examination of these patients is warranted; (iv) Despite relapses, the overall prognosis of patients with pediatric skin vasculitides is good, with the exception of those with the urticarial vasculitis type.
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