Maşallah CANDEMİR, Hülya HALİS, Aziz POLAT, Hacer ERGİN, İlknur KILIÇ, Serap SEMİZ, Mine CİNBİŞ

HENOCH-SCHONLEIN PURPURALI HASTALARIN ANALİZİ

Amaç:HSP'li hastalarımızın epidemiyolojik ve klinik özellikleri, laboratuar bulguları ve hastalığın seyrininincelenmesi amaçlandı.Yöntem:2000-2006 yılları arasında, hastanemiz Çocuk Sağlığı ve Hastalıkları Kliniği'nde Henoch-SchonleinPurpurası tanısı alan ve izlenen 45 hasta retrospektif olarak incelendi.Bulgular:Hastaların 27 (%60,0)'si kız, 18 (%40,0)'i erkek, kız / erkek oranı 1.5 idi. Yaş ortalaması 6 yaş 9 ay (8ay-14 yaş) olarak saptandı. Başvuru şikayetleri sıklık sırasına göre döküntü (%100), yürüyememe ve/veya eklemağrısı (%71,1) ve karın ağrısı (%40,0) idi. Hastaların % 57,7'inde ortalama 12 gün önce geçirilmiş enfeksiyonöyküsü tespit edildi. Fizik muayenede purpurik döküntü (alt ekstremite ve gluteal bölgede %100, yaygın %11,1),artrit (32 hastada, %71,1, en sık ayak bileği ve diz eklemlerinde), ateş (9 hastada, %20,0) bulundu. Laboratuarbulguları anemi (8/45 hasta, %17,7), lökositoz (6/45 hasta, %13,3), trombositoz (16/45 hasta, %35,5),sedimentasyon yüksekliği (16/25 hasta, %64,0), CRP pozitifliği (33/34 hasta, %97,0), hematüri (4/45 hasta,%8,8), proteinüri (2/45 hasta, %,4,4), gaitada gizli kan pozitifliği (14/42 hasta, %33,3) bulundu. Hematüri veproteinüri devam etmediği için hiçbir hastada böbrek biyopsisine gerek duyulmadı. Gastrointestinal sistemtutulumu olduğu düşünülen 17 hastaya steroid tedavisi başlandı ve ortalama 9.1 gün kullanıldı. Perforasyon,invaginasyon gözlenmedi. Ortalama 15. günde 9 hastada relaps görüldü. Santral sinir sistemi tutulumu hiçbirhastada yoktu.Sonuç:Henoch-Schonlein Purpurası çocukluk çağında sık görülen benign karakterli bir hastalık olupkomplikasyon ve sekel oranı oldukça düşüktür

Anahtar Kelimeler:

Henoch-Schönlein purpurası, vaskülit

Analysis of Patients With Henoch-Schönlein Purpura

Aim: The aim of this study was to investigate the clinical and epidemiologic features, laboratory finding and outcome of disease in our patients with Henoch-Schönlein purpura. Methods: Fourty-five patients with Henoch-Schönlein purpura who were diagnosed and observed in our department of pediatrics between 2000-2006 were retrospectively evaluated. Results: Twentyseven (60.0%) of the patients were female and 18 (40.0%) were male, female to male ratio was1.5. Mean age of the patients was 6 year 9 months (8 months-14 years). İnitial symptoms and findings in the time of admission with decreasing frequency were purpura (100%), disability to walk and/or arthralgia (71.1%) ve stomachache (40.0%). An infection history was present in 57.7% of the patients in the last 12 days. In physical examination, purpura (lower extremity and hips 100%, diffuse 11.1%), arhtritis (32 patients, 71.1%, mostly diffused on ankle and knee), fever (9 patients, 20,0%) were discovered. Anaemia (8/45 patients, 17.7%), leukocytosis (6/45 patients, 13.3%), trombocytosis (16/45 patients, 35.5%), increased erythrocyte sedimentation rate (16/25 patients, 64.0%), positive CRP (33/34 patients, 97.0%), hematuria (4/45 patients, 8.8%), proteinuria (2/45 patients, 4.4%), positive fecal blood tests (14/42 patients, 33.3%) were determined. Renal biopsy was not needed as there was no persistant hematuria and proteinuria. 17 patients who had gastrointestinal involvement were treated with steroid therapy for a mean period of 9.1 days. Perforation and invagination was not observed. Relapse was seen in 9 patients. (mean duration 15th day). There was no nervous system involvement in any patients. Conclusion: Henoch-Schonlein Purpura is a frequent benign disease of childhood. Complicatios and sequeles are infrequent.

Keywords:

Henoch-Schönlein purpura, vasculitis,

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