The relationship between initial clinical findings and renal involvement of henoch schönlein purpura in pediatric patients

Abstract

OBJECTIVE: Henoch-Schönlein purpura (HSP) is an IgA-associated systemic vasculitis characterized by three important clinical signs of non-thrombocytopenic palpable purpura, abdominal pain, and arthritis. Renal involvement generally determines the prognosis. In this study, it was aimed to determine the relationship between skin, gastrointestinal system (GIS), the severity of joint and renal involvement on the clinical features of children who were followed up with the diagnosis of HSP. MATERIAL AND METHODS: In this prospective cross-sectional study, 74 pediatric patients followed up between January 2011 and January 2012 were evaluated with their history, physical examination, laboratory measurements, treatment received during follow-up, and response to treatment. System involvement of the patients was classified as skin, renal, GIS, and joint involvement. RESULTS: It was determined that 45.9% of the cases were female and 54.1% were male. A significant correlation was found between the severity of arthritis and renal involvement in the first month (p<0.05). There was a significant correlation between the severity of abdominal pain and renal involvement at the time of admission, and also the severity of abdominal pain and severity of renal involvement at the sixth month (p<0.05). A significant correlation was found between the response of abdominal pain to painkillers and renal involvement in the first month (p<0.05). CONCLUSIONS: Severe joint and GIS involvement at the beginning of the disease and severe GIS involvement at the beginning were found to be associated with severe renal involvement in the first and sixth months. Patients who initially had severe abdominal pain, and therefore could not move at all, fall behind from the game, prefer to lie down continuously, and/or those with melena should be evaluated more carefully in terms of renal involvement.