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Henoch-Schönlein purpura in Chinese children and adults
1Department of Pediatrics, Chang Gung Children's Hospital, Kweishan, Taoyuan, Taiwan.
Insights
Henoch-Schönlein purpura (HSP) presents differently in children and adults. Adults experienced more severe kidney issues, while children had more abdominal pain and inflammation markers.
Area of Science:
- Pediatrics
- Nephrology
- Rheumatology
Background:
- Henoch-Schönlein purpura (HSP) is a common vasculitis affecting children and adults.
- Understanding age-specific differences in HSP presentation and outcomes is crucial for effective management.
Purpose of the Study:
- To compare the clinical characteristics, laboratory findings, and outcomes of Henoch-Schönlein purpura (HSP) in children and adults.
- To identify distinct patterns of disease expression between pediatric and adult patients diagnosed with HSP.
Main Methods:
- Retrospective analysis of 84 children and 38 adults diagnosed with Henoch-Schönlein purpura (HSP) between 1987 and 1996.
- Review of medical records, including clinical symptoms, laboratory results, skin biopsy findings (leukocytoclastic vasculitis in adults), and patient outcomes.
Main Results:
- Male predominance was observed in children, but not adults. Children reported more frequent abdominal pain (70.2% vs 28.9%).
- Adults exhibited more severe renal involvement, including higher rates of hypertension (P < 0.05) and heavy proteinuria (P < 0.01).
- Children showed more frequent leukocytosis, thrombocytosis, and elevated C-reactive protein, whereas adults had higher IgA and cryoglobulin levels during acute attacks.
Conclusions:
- Henoch-Schönlein purpura (HSP) demonstrates distinct clinical and laboratory differences between pediatric and adult populations.
- While prognosis is generally good, adults with HSP face a higher risk of severe renal complications, including end-stage renal disease.
Abstract:
From 1987 to 1996, we retrospectively analyzed 84 children and 38 adults admitted to Chang Gung Memorial Hospital with the diagnosis of Henoch-Schönlein purpura (HSP). All of the adult patients had skin biopsy finding showing leukocytoclastic vasculitis. Male predominance was noted in children, but not in adults. Preceding infection was noted in 40.5% of children and 31.6% of the adults (P = 0.46). 8.3% of children and 13.2% of adults had medication intake at disease onset (P = 0.62). Children had more frequent abdominal pain than the adults (70.2% vs 28.9%, P < 0.01). Renal involvement was more common and severe in adults, manifested as more frequent hypertension (P < 0.05) and heavy proteinuria (P < 0.01). During acute attack, leukocytosis, thrombocytosis, elevation of serum C-reactive protein levels were more frequently observed in children, while elevated serum IgA and cryoglobulin levels were more common in adults. The overall prognosis was good in both age groups, although two adults developed end stage renal disease. Our study demonstrated the different expression of HSP in Chinese children and adults.