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ÇOCUK HASTALARDA HENOCH SCHÖNLEIN PURPURASINDA BAŞLANGIÇ KLİNİK BULGULARI İLE BÖBREK TUTULUMU ARASINDAKİ İLİŞKİ

Year 2023, Volume: 24 Issue: 4, 452 - 456, 09.10.2023

Dilek Çavuşoğlu Ülkü Yıldırımer Muhammet Ali Kanık Mehmet Helvaci Ali Rahmi Bakiler Onder Yavascan

https://doi.org/10.18229/kocatepetip.1180611

Abstract

AMAÇ: Henoch-Schönlein purpurası (HSP) non-trombositopenik palpabıl purpura, karın ağrısı ve artritten oluşan üç önemli klinik bulgu ile karakterize IgA ilişkili sistemik bir vaskülittir. Böbrek tutulumu genellikle prognozu belirlemektedir. Bu çalışmada HSP tanısı ile izlenen çocukların klinik özelliklerini; cilt, gastrointestinal sistem (GİS), eklem ve böbrek tutulumunun şiddeti arasındaki ilişkinin belirlenmesi amaçlandı.
GEREÇ VE YÖNTEM: İleriye yönelik kesitsel olarak düzenlenen bu çalışmaya Ocak 2011 - Ocak 2012 tarihleri arasında izlenen 74 çocuk hasta öykü, fizik muayene, laboratuvar ölçümleri, izlemde aldıkları tedavi ve tedaviye alınan cevapla değerlendirildi. Hastaların sistem tutulumları deri, böbrek, GİS ve eklem tutulumu olarak sınıflandırıldı.
BULGULAR: Olguların %45,9’u kız, %54,1’i erkek olarak saptandı. İlk bir ayda artrit şiddeti ve böbrek tutulumu arasında anlamlı bir ilişki bulundu (p<0,05). Başvuru anında karın ağrısı şiddeti ile böbrek tutulumu arasında ve ayrıca altıncı ayda karın ağrısı şiddeti ve böbrek tutulumu şiddeti arasında anlamlı bir korelasyon saptandı (p<0,05). İlk bir ayda karın ağrısının ağrı kesiciye yanıtı ile böbrek tutulumu arasında anlamlı bir ilişki bulundu (p<0,05).
SONUÇ: Hastalığın başlangıcında ağır eklem ve GİS tutulumu ile başlangıçta GİS tutulumunun ağır olması 1. ve 6. ayda ağır böbrek tutulumu ile ilişkili bulundu. Başlangıçta şiddetli karın ağrısı olan bu nedenle hiç hareket edemeyen, oyundan geri kalan, sürekli yatmayı tercih eden olan ve/veya melena saptanan olgular böbrek tutulumu açısından daha dikkatli değerlendirilmelidir

Keywords

Vaskülit Böbrek Çocuk.

References

  • 1. Szer IS. Henoch-Schönlein purpura: When and how to treat. J Rheumatol. 1996;23:1661-5.
  • 2. Anil M, Aksu N, Kara OD, et al. Henoch-Schönlein purpura in children from Western Turkey: A retrospective analysis of 430 cases. Turkish J Pediatr. 2009;51:429-36.
  • 3. Bagga A, Dillon MJ. Leukocytoclastic vasculitis. In: Cassidy JT, Petty RE (eds). Textbook of Pediatric Rheumatology, Philadelphia. WB Saunders Company. 2001;569-79.
  • 4. Nielsen HE. Epidemiology of Schönlein Henoch purpura. Acta Pediatr Scand. 1988;77:125-31.
  • 5. Athreya BH. Vasculitis in Children. Ped Clin N Am. 1995;42:1239-61.
  • 6. Miller ML, Pachman LM. Vasculitis syndromes: Henoch-Schönlein purpura. In Behrman RE, Kliegman RB, Jensen HB (eds). Nelson Textbook of Pediatrics. 16th edit. Philadelphia: WB Sunders. 2000:729-29.
  • 7. Cassidy JT, Pretty RE. Vasculitis In Textbook of Pediatric Rheumatology. Philadelphia: WB Saunders Company, 1995;365-422.
  • 8. Kang Y, Park JS, Ha YJ, et al. Differences in clinical manifestations and outcomes between adult and child patients with Henoch-Schönlein purpura. J Korean Med Sci. 2014;29:198-203.
  • 9. Yang HR, Choi WJ, Ko JS, Seo JK. Intravenous immunoglobulin for severe gastrointestinal manifestation of Henoch-Schnlein purpura refractory to corticosteroid therapy. Korean J Pediatr. 2006;49:784-9.
  • 10. Beşbaş N, Saatçi Ü, Ruacan S, et al. The role of cytokines in Henoch- Schönlein Purpura. Scan J Rheumatology. 1997;26:456-60.
  • 11. Cassidy JT, Petty RE. Vasculitis and its classification. In: Cassidy JT, Petty RE, Laxer RM, Lindsley CB. Textbook of Pediatric Rheumatology. Elsevier Saunders, Philadelphia, 2005;492-96.
  • 12. Kendirli S, İnal A. Clinical Features of Children Diagnosed with Henoch-Schönlein Purpura. Erciyes Medical Journal. 2009;31:153-61.
  • 13. Candemir M, Halis H, Polat A. Analysis of Patients with Henoch-Schönlein Purpura. ADU Medical Faculty Journal. 2006;7:39-43.
  • 14. Çakıcı EK, Gür G, Yazılıtaş F, et al. A retrospective analysis of children with Henoch-Schonlein purpura and re-evaluation of renal pathologies using Oxford classification. Clin Exp Nephrol. 2019 ;23:939-47.
  • 15. Garcia JL, Blanco OA, Banez MJS, İbanez MJS, Ortega PJ, Zamora MI. Outcome of Henoch-Schönlein nephropathy in pediatric patients. Nefrologia. 2008;28:627-32.
  • 16. Jauhola O, Ronkainen J, Koskimies O, et al. Renal manifestations of Henoch-Schonlein purpura in a 6-month prospective study of 223 children. Arch Dis Child. 2010;95:877-82.
  • 17. Gökçe Ş, Kurugöl Z, Koturoğlu G, Aslan A. Predictive role of laboratory markers and clinical features for recurrent Henoch-Schönlein Purpura in childhood: A study from Turkey. Mod Rheumatol. 2020;30:1047-52.
  • 18. Paek EY, Yi DY, Kang B, Choe BH. Fecal calprotectin as a marker of gastrointestinal involvement in pediatric Henoch-Schönlein purpura patients: a retrospective analysis. BMC Pediatr. 2020;20(1):374.
  • 19. Kanik A, Baran M, Ince FD, et al. Faecal calprotectin levels in children with Henoch-Schönlein purpura: is this a new marker for gastrointestinal involvement? Eur J Gastroenterol Hepatol. 2015;27:254-8.
  • 20. Arslan S, Saatçi Ü. Henoch-Schönlein Purpura. Katkı Pediatri Dergisi. 1995;2:165-74.
  • 21. Ekinci RMK, Balci S, Melek E, et al. Clinical manifestations and outcomes of 420 children with Henoch Schönlein Purpura from a single referral center from Turkey: A three-year experience. Mod Rheumatol. 2020;30:1039-46.
  • 22. Chan H, Tang YL, Lv XH, et al. Risk Factors Associated with Renal Involvement in Childhood Henoch-Schönlein Purpura: A Meta-Analysis. PLoS One. 2016;11:e0167346.
  • 23. Trapani S, Micheli A. Henoch-Schönlein purpura in childhood. Semin Arthritis Rhem. 2005;35:143-53.
  • 24. Peru H, Soylemezoğlu O, Bakkaloğlu S, et al. Henoch Schonlein purpura in childhood: clinical analysis of 254 cases over a 3-year period. Clin Rheumaol. 2008;27:1087-92.
  • 25. Kaku Y, Nohara K, Honda S. Renal involvement in Henoch-Schonlein purpura: a multivariate analysis of prognostic factors. Kidney International. 1998;53:1755-9.
  • 26. Akça Ü, Akca G, Nalcacıoğlu H, et al. Evaluation of epidemiological, clinical and laboratory findings in Henoch Schönlein purpura. Turkish Journal of Family Practice. 2020;24:87-94.
  • 27. Ozturk K, Cakan M. Initial manifestations and short term follow-up results of Henoch-Schönlein purpura in children: A report from two centers. North Clin Istanb. 2020;7:341-7.

THE RELATIONSHIP BETWEEN INITIAL CLINICAL FINDINGS AND RENAL INVOLVEMENT OF HENOCH SCHÖNLEIN PURPURA IN PEDIATRIC PATIENTS

Year 2023, Volume: 24 Issue: 4, 452 - 456, 09.10.2023

Dilek Çavuşoğlu Ülkü Yıldırımer Muhammet Ali Kanık Mehmet Helvaci Ali Rahmi Bakiler Onder Yavascan

https://doi.org/10.18229/kocatepetip.1180611

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.

Keywords

Vasculitis Kidney Child.

References

  • 1. Szer IS. Henoch-Schönlein purpura: When and how to treat. J Rheumatol. 1996;23:1661-5.
  • 2. Anil M, Aksu N, Kara OD, et al. Henoch-Schönlein purpura in children from Western Turkey: A retrospective analysis of 430 cases. Turkish J Pediatr. 2009;51:429-36.
  • 3. Bagga A, Dillon MJ. Leukocytoclastic vasculitis. In: Cassidy JT, Petty RE (eds). Textbook of Pediatric Rheumatology, Philadelphia. WB Saunders Company. 2001;569-79.
  • 4. Nielsen HE. Epidemiology of Schönlein Henoch purpura. Acta Pediatr Scand. 1988;77:125-31.
  • 5. Athreya BH. Vasculitis in Children. Ped Clin N Am. 1995;42:1239-61.
  • 6. Miller ML, Pachman LM. Vasculitis syndromes: Henoch-Schönlein purpura. In Behrman RE, Kliegman RB, Jensen HB (eds). Nelson Textbook of Pediatrics. 16th edit. Philadelphia: WB Sunders. 2000:729-29.
  • 7. Cassidy JT, Pretty RE. Vasculitis In Textbook of Pediatric Rheumatology. Philadelphia: WB Saunders Company, 1995;365-422.
  • 8. Kang Y, Park JS, Ha YJ, et al. Differences in clinical manifestations and outcomes between adult and child patients with Henoch-Schönlein purpura. J Korean Med Sci. 2014;29:198-203.
  • 9. Yang HR, Choi WJ, Ko JS, Seo JK. Intravenous immunoglobulin for severe gastrointestinal manifestation of Henoch-Schnlein purpura refractory to corticosteroid therapy. Korean J Pediatr. 2006;49:784-9.
  • 10. Beşbaş N, Saatçi Ü, Ruacan S, et al. The role of cytokines in Henoch- Schönlein Purpura. Scan J Rheumatology. 1997;26:456-60.
  • 11. Cassidy JT, Petty RE. Vasculitis and its classification. In: Cassidy JT, Petty RE, Laxer RM, Lindsley CB. Textbook of Pediatric Rheumatology. Elsevier Saunders, Philadelphia, 2005;492-96.
  • 12. Kendirli S, İnal A. Clinical Features of Children Diagnosed with Henoch-Schönlein Purpura. Erciyes Medical Journal. 2009;31:153-61.
  • 13. Candemir M, Halis H, Polat A. Analysis of Patients with Henoch-Schönlein Purpura. ADU Medical Faculty Journal. 2006;7:39-43.
  • 14. Çakıcı EK, Gür G, Yazılıtaş F, et al. A retrospective analysis of children with Henoch-Schonlein purpura and re-evaluation of renal pathologies using Oxford classification. Clin Exp Nephrol. 2019 ;23:939-47.
  • 15. Garcia JL, Blanco OA, Banez MJS, İbanez MJS, Ortega PJ, Zamora MI. Outcome of Henoch-Schönlein nephropathy in pediatric patients. Nefrologia. 2008;28:627-32.
  • 16. Jauhola O, Ronkainen J, Koskimies O, et al. Renal manifestations of Henoch-Schonlein purpura in a 6-month prospective study of 223 children. Arch Dis Child. 2010;95:877-82.
  • 17. Gökçe Ş, Kurugöl Z, Koturoğlu G, Aslan A. Predictive role of laboratory markers and clinical features for recurrent Henoch-Schönlein Purpura in childhood: A study from Turkey. Mod Rheumatol. 2020;30:1047-52.
  • 18. Paek EY, Yi DY, Kang B, Choe BH. Fecal calprotectin as a marker of gastrointestinal involvement in pediatric Henoch-Schönlein purpura patients: a retrospective analysis. BMC Pediatr. 2020;20(1):374.
  • 19. Kanik A, Baran M, Ince FD, et al. Faecal calprotectin levels in children with Henoch-Schönlein purpura: is this a new marker for gastrointestinal involvement? Eur J Gastroenterol Hepatol. 2015;27:254-8.
  • 20. Arslan S, Saatçi Ü. Henoch-Schönlein Purpura. Katkı Pediatri Dergisi. 1995;2:165-74.
  • 21. Ekinci RMK, Balci S, Melek E, et al. Clinical manifestations and outcomes of 420 children with Henoch Schönlein Purpura from a single referral center from Turkey: A three-year experience. Mod Rheumatol. 2020;30:1039-46.
  • 22. Chan H, Tang YL, Lv XH, et al. Risk Factors Associated with Renal Involvement in Childhood Henoch-Schönlein Purpura: A Meta-Analysis. PLoS One. 2016;11:e0167346.
  • 23. Trapani S, Micheli A. Henoch-Schönlein purpura in childhood. Semin Arthritis Rhem. 2005;35:143-53.
  • 24. Peru H, Soylemezoğlu O, Bakkaloğlu S, et al. Henoch Schonlein purpura in childhood: clinical analysis of 254 cases over a 3-year period. Clin Rheumaol. 2008;27:1087-92.
  • 25. Kaku Y, Nohara K, Honda S. Renal involvement in Henoch-Schonlein purpura: a multivariate analysis of prognostic factors. Kidney International. 1998;53:1755-9.
  • 26. Akça Ü, Akca G, Nalcacıoğlu H, et al. Evaluation of epidemiological, clinical and laboratory findings in Henoch Schönlein purpura. Turkish Journal of Family Practice. 2020;24:87-94.
  • 27. Ozturk K, Cakan M. Initial manifestations and short term follow-up results of Henoch-Schönlein purpura in children: A report from two centers. North Clin Istanb. 2020;7:341-7.
There are 27 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Articles
Authors

Dilek Çavuşoğlu 0000-0003-4924-5300

Ülkü Yıldırımer 0000-0002-3281-8611

Muhammet Ali Kanık 0000-0003-3304-0992

Mehmet Helvaci 0000-0003-3265-8475

Ali Rahmi Bakiler 0000-0001-8234-3071

Onder Yavascan 0000-0002-3582-5075

Publication Date October 9, 2023
Acceptance Date February 8, 2023
Published in Issue Year 2023 Volume: 24 Issue: 4

Cite

APA Çavuşoğlu, D., Yıldırımer, Ü., Kanık, M. A., Helvaci, M., et al. (2023). THE RELATIONSHIP BETWEEN INITIAL CLINICAL FINDINGS AND RENAL INVOLVEMENT OF HENOCH SCHÖNLEIN PURPURA IN PEDIATRIC PATIENTS. Kocatepe Tıp Dergisi, 24(4), 452-456. https://doi.org/10.18229/kocatepetip.1180611
AMA Çavuşoğlu D, Yıldırımer Ü, Kanık MA, Helvaci M, Bakiler AR, Yavascan O. THE RELATIONSHIP BETWEEN INITIAL CLINICAL FINDINGS AND RENAL INVOLVEMENT OF HENOCH SCHÖNLEIN PURPURA IN PEDIATRIC PATIENTS. KTD. October 2023;24(4):452-456. doi:10.18229/kocatepetip.1180611
Chicago Çavuşoğlu, Dilek, Ülkü Yıldırımer, Muhammet Ali Kanık, Mehmet Helvaci, Ali Rahmi Bakiler, and Onder Yavascan. “THE RELATIONSHIP BETWEEN INITIAL CLINICAL FINDINGS AND RENAL INVOLVEMENT OF HENOCH SCHÖNLEIN PURPURA IN PEDIATRIC PATIENTS”. Kocatepe Tıp Dergisi 24, no. 4 (October 2023): 452-56. https://doi.org/10.18229/kocatepetip.1180611.
EndNote Çavuşoğlu D, Yıldırımer Ü, Kanık MA, Helvaci M, Bakiler AR, Yavascan O (October 1, 2023) THE RELATIONSHIP BETWEEN INITIAL CLINICAL FINDINGS AND RENAL INVOLVEMENT OF HENOCH SCHÖNLEIN PURPURA IN PEDIATRIC PATIENTS. Kocatepe Tıp Dergisi 24 4 452–456.
IEEE D. Çavuşoğlu, Ü. Yıldırımer, M. A. Kanık, M. Helvaci, A. R. Bakiler, and O. Yavascan, “THE RELATIONSHIP BETWEEN INITIAL CLINICAL FINDINGS AND RENAL INVOLVEMENT OF HENOCH SCHÖNLEIN PURPURA IN PEDIATRIC PATIENTS”, KTD, vol. 24, no. 4, pp. 452–456, 2023, doi: 10.18229/kocatepetip.1180611.
ISNAD Çavuşoğlu, Dilek et al. “THE RELATIONSHIP BETWEEN INITIAL CLINICAL FINDINGS AND RENAL INVOLVEMENT OF HENOCH SCHÖNLEIN PURPURA IN PEDIATRIC PATIENTS”. Kocatepe Tıp Dergisi 24/4 (October 2023), 452-456. https://doi.org/10.18229/kocatepetip.1180611.
JAMA Çavuşoğlu D, Yıldırımer Ü, Kanık MA, Helvaci M, Bakiler AR, Yavascan O. THE RELATIONSHIP BETWEEN INITIAL CLINICAL FINDINGS AND RENAL INVOLVEMENT OF HENOCH SCHÖNLEIN PURPURA IN PEDIATRIC PATIENTS. KTD. 2023;24:452–456.
MLA Çavuşoğlu, Dilek et al. “THE RELATIONSHIP BETWEEN INITIAL CLINICAL FINDINGS AND RENAL INVOLVEMENT OF HENOCH SCHÖNLEIN PURPURA IN PEDIATRIC PATIENTS”. Kocatepe Tıp Dergisi, vol. 24, no. 4, 2023, pp. 452-6, doi:10.18229/kocatepetip.1180611.
Vancouver Çavuşoğlu D, Yıldırımer Ü, Kanık MA, Helvaci M, Bakiler AR, Yavascan O. THE RELATIONSHIP BETWEEN INITIAL CLINICAL FINDINGS AND RENAL INVOLVEMENT OF HENOCH SCHÖNLEIN PURPURA IN PEDIATRIC PATIENTS. KTD. 2023;24(4):452-6.
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