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Henoch-Schonlein purpura: the Chandigarh experience
1Department of Pediatrics, Postgraduate Institute of Medical Eduation and Research, Chandigarh.
Objective:
To determine the clinical profile of children with Henoch-Schonlein purpura (HSP).
Design:
Hospital based descriptive follow-up study.
Subjects:
45 patients attending the Pediatric Rheumatology and Immunology clinic over the last 4 years.
Results:
The patients were aged between 2.5-12 years with a male to female ratio of 2:1. All cases had palpable purpura. Gastrointestinal involvement was seen in 38 patients, with abdominal pain in 35 (78%) and lower GI bleed in 21 (47%). Large joint arthritis occurred in 60%. Renal involvement was seen in 14 subjects (31%). Major renal involvement occurred in 9 patients, with nephritic syndrome in 6 and nephrotic syndrome in 3 cases. Five patients had minor urinary abnormalities; 6 patients with major renal involvement and crescentic glomerulonephritis were treated with high dose pulse steroid therapy followed by oral prednisolone and azathioprine for 12-18 months. Normalization of urinary abnormalities occurred in these patients over 4-8 months and presently all are normotensive and off antihypertensive drugs.
Conclusions:
HSP in children is a common form of vasculitis. Though short term results in HSP nephritis have been good, long term prognosis in those with major renal involvement would remain guarded.