MUSTAFA AYDIN, Mustafa DEMİROL, Abdullah KURT, Çıtak A. Neşe KURT, Erdal YILMAZ

Henoch-Schönlein purpuralı vakalarımızın değerlendirilmesi

Amaç: Henoch-Schönlein purpurası, etiyolojisi kesin olarak bilinmeyen sistemik küçük damarların lökositoklastik vaskülitidir. Henoch-Schönlein purpuralı hastalarımızın klinik ve epidemiyolojik özelliklerinin incelenmesi amaçlandı. Yöntem: Ocak 2000 ile Aralık 2004 tarihleri arasında kliniğimize başvuran ve Henoch-Schönlein purpurası tanısı alan 50 hasta retrospektif olarak incelendi. Bulgular: Vakaların yaş ortalaması 7.5±3.1 yıl idi. Bunlardan 28 (% 56)'i erkek, 22 (% 44)'si kızdı. İnfeksiyon öyküsü hastaların 19 (% 38)'unda, ilaç alımı 8 (% 16)'inde vardı. Mevsimlere göre değerlendirildiklerinde 17 (% 34)'sinin sonbahar, 15 (% 30)'nin kış aylarında başvurdukları görüldü. Hastaların 31 (% 62)'inde purpura, 11 (% 22)'inde artralji, 6 (% 12)'sında GİS tutulumu ve 2 (% 4)'sinde artrit başvuru sırasındaki ilk bulgu veya yakınmaları oluşturmaktaydı. Genel olarak purpura hastaların tümünde (% 100), gastrointestinal tutulum 34 (% 68), eklem tutulumu 31 (% 62) ve renal tutulum 15 (% 30) hastada belirlendi. Skalp ödemi 2, skrotal ödem 3 hastada vardı. Akut batın tablosu 4 (% 8) vakada bulunurken, bunlardan birine cerrahi uygulanmıştı. Laboratuvar değerlerinden beyaz küre sayısı ortalama 14,224±7246/mm3, trombosit sayısı 411,080±114,769/mm3 ve eritrosit sedimentasyon hızı 22.1±17.7 mm/h idi. İmmunoglobulin A (IgA) düzeyi hastaların 11 (% 22)'inde yüksek bulundu. Bir hastada kronik böbrek yetmezliği gelişmişti. Vakaların 24 (% 48)'üne steroid tedavisi uygulanmıştı. Sonuç: Klinik özellikler ve laboratuvar verilerine dayanarak Henoch-Schönlein purpurası tanısının düşünülmesi, gereksiz tetkik ve girişimi önleyeceği gibi hastanın erken takibe alınmasına da olanak sağlayacaktır.

Anahtar Kelimeler:

Purpura, Schoenlein-Henoch, Vaskülit, Geriyedönük çalışma, Çocuk

The evaluation of the our patients with Henoch-Schönlein purpura

Aim: Henoch-Schönlein purpura is a leukocytoclastic vasculitis involving systemic small vessels which has still unknown etiology. The aim of this study was to investigate the clinical and epidemiologic features of the patients with Henoch-Schönlein purpura. Methods: We retrospectively evaluated the files of 50 patients with Henoch-Schönlein purpura who was admitted to our hospital between January 2000 and December 2004. Results: The mean age of patients was 7.5±3.1 years. Among them 28 (56 %) were male and 22 (44 %) female. A preceding infection history was present in 19 (38 %) and drug intake in 8 (16 %) of out of the patients. It was evident that the disease manifested in fall and winter months in 17 (34 %) and 15 (30 %) patients, respectively. Purpura in 31 (62 %), arthralgia in 11 (22 %), gastrointestinal involvement in 6 (12 %), and arthritis in 2 (4 %) of patients were the initial symptoms or findings at the time of admission. In general, purpura was present in all patients (100 %) and involvement of gastrointestinal system in 34 (68 %), join in 31 (% 62) and kidney in 15 (30 %) out of the patients. Scalp and scrotal edema was found in 2 and 3 patients, respectively. There was severe abdominal pain in 4 (8 %) patients, but one of them had had a surgical intervention. In the laboratory studies the mean white blood cell count was 14,224±7246/mm3, platelet count 411,080 ± 114,769/mm3, and erythrocyte sedimentation rate of 22.1±17.7 mm/h. The IgA levels were found as high in 11 (22 %) out of the patients. One had had chronic renal failure. Twenty-four (48 %) of them had received steroid regimens. Conclusion: The consideration of the diagnosis of Henoch-Schönlein purpura based on the clinical features and laboratory data can be prevent the unnecessary investigations and interventions, and also give opportunity to put the patients on early follow-up program.

Keywords:

Purpura, Schoenlein-Henoch, Vasculitis, Retrospective Studies, Child,

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