Retrospective evaluation of Henoch Schoenlein Purpura cases

Objective: Henoch Schönlein Purpura (HSP) is the most common benign vasculitis occurring during childhood. Morbidity and mortality rates rise when there is organ system involvement. We aimed to retrospectively evaluate HSP cases in our clinic according to organ involvement, clinical and laboratory findings. Material and Methods: Twenty-eight HSP cases were followed in our clinic from January 1 st 1997 to June 1st 2000. The cases were retrospectively evaluated. Results: The mean age of the patients was 7.96 years (interval: 3-14 yrs.). 17 of them were males, 11 were females. The mean hospitalization period was 6,36 days (interval: 1-16 days). Two patients had been hospitalized twice due to recurrence and two others had each been hospitalized once before in another clinic due to the same disease. 9 patients (32.1 %) had a history of an upper respiratory tract infection (URTI) of whom 3 (10.7 %) had positive throat cultures for beta hemolytic streptococcus. Skin lesions were seen in all patients. Arthritis/arthralgia developed in 12 (42.9 %) patients. Gastrointestinal system tract (GIT) involvement developed in 19 patients (67.9 %), 7 (25 %) of them presented with abdominal pain and vomiting, 12 (42.9 %) with occult fetal blood. In 4 patients (14.3 %) with GIT involvement, hematochezia and melena developed later. Abdominal ultrasonography was performed on 17 cases (60.7 %). No surgical intervention was required for any of the patients. 11 patients (39,3 %) had renal involvement. In 8 of the cases (28,6 %) renal disease presented with microscopic hematuria with or without proteinuria and in the other 3 (10,7 %) with macroscopic hematuria. In 1 (3.6 %) case acute renal failure developed and hemodialysis was performed. Central nervous system (CNS) involvement occurred in one patient (3,6 %) who had convulsions. In 2 cases (7.1%) scrotal involvement was observed. 13 patients were given steroids. Conclusions: In HSP cases, renal and GIT involvement should be searched for meticulously and patients with renal involvement should be followed up regularly.