scholarly journals Henoch-Schonlein Purpura in Children: The Role of Corticosteroids

2019 ◽  
Vol 7 (11) ◽  
pp. 1812-1814
Author(s):  
Bella Kurnia
Keyword(s):  
Abdominal Pain ◽  
Renal Disease ◽  
Systemic Vasculitis ◽  
Small Vessel ◽  
Small Vessel Vasculitis ◽  
Henoch Schonlein Purpura ◽  
Progression Of Renal Disease ◽  
Schonlein Purpura ◽  
Henoch Schönlein Purpura

BACKGROUND: Henoch- schonlein purpura (HSP) is an IgA- mediated systemic small vessel vasculitis. It is the most common form of systemic vasculitis in children.CASE REPORT: A 9 years old girl admitted to the hospital with chief complain of purplish red rash on both legs since approximately 1 week with painful knees and ankles that make the patient unable to walk. The patient was diagnosed with HSP and was treated with corticosteroid and analgesics. The patients only stayed for 2 nights at the hospital and discharged from the hospital with the ability to walk and experience no pain. CONCLUSION: The role of corticosteroids in the treatment of HSP is still controversial. But from various research, we can conclude that the role of corticosteroid in HSP is as a symptom reliever (reduce abdominal pain and arthritis), but does not slow the progression of renal disease.

scholarly journals HENOCH-SCHÖNLEIN PURPURA Z NEZNAČILNIM POTEKOM BOLEZNI – predstavitev treh primerov in pregled literature

2016 ◽  
Vol 85 (2) ◽  
Author(s):  
Daša Kumprej ◽  
Tomaž Krenčnik ◽  
Aleksandra Aleksandrova Oberstar ◽  
Nataša Toplak
Keyword(s):  
Abdominal Pain ◽  
Renal Disease ◽  
Blood Vessels ◽  
Current Literature ◽  
Atypical Presentation ◽  
Disease Course ◽  
Henoch Schonlein Purpura ◽  
Skin Manifestation ◽  
Schonlein Purpura ◽  
Henoch Schönlein Purpura

Background: Henoch-Schönlein purpura is the most common vasculitis of small blood vessels in children. The diagnosis of the disease is confirmed in a patient with a specific rash, joint inflamation, abdominal pain or renal disease. The specific rash is necesary for the confirmation of the diagnosis. Henoch-Schönlein purpura can rarely present with a complication withot a prior presentation of the rash. In these cases diagnosis is difficult until the presentation of the specific skin manifestation. In the majority of patients the disease course is not complicated and has a good prognosis.Conclusion: In this article we present three patients with an atypical presentation of the disease and a review of current literature on the topic.

Steroid Effects on the Course of Abdominal Pain in Children With Henoch-Schonlein Purpura

PEDIATRICS ◽  
1987 ◽  
Vol 79 (6) ◽  
pp. 1018-1021
Author(s):  
NORMAN D. ROSENBLUM ◽  
HARLAND S. WINTER
Keyword(s):  
Abdominal Pain ◽  
Gastrointestinal Symptom ◽  
Systemic Vasculitis ◽  
Skin Lesions ◽  
Intestinal Bleeding ◽  
Controlled Trials ◽  
Henoch Schonlein Purpura ◽  
Intestinal Lesions ◽  
Schonlein Purpura ◽  
Henoch Schönlein Purpura

Henoch-Schonlein purpura is a systemic vasculitis of unknown cause that is characterized primarily by abdominal pain, arthritis, and purpuric skin lesions. Abdominal pain is the most common gastrointestinal symptom, but intestinal bleeding and intussusception may occur. Previous studies have supported the use of steroids in managing the abdominal pain of Henoch-Schonlein purpura.1,2 Because there are no controlled trials using steroids in this disease, their value in affecting the intestinal lesions of Henoch-Schonlein purpura remains unknown. The purpose of this retrospective study was to assess the effect of corticosteroids on the outcome of abdominal pain in children with Henoch-Schonlein purpura. PATIENTS AND METHODS

Altered mean platelet volume in children with Henoch-Schonlein purpura and its association with disease activity

2017 ◽  
Vol 55 (3) ◽  
pp. 368-372
Author(s):  
Xiang Shi ◽  
Wen-Chao Li ◽  
Li-Jun Mo ◽  
Xiao-Hong Li ◽  
Yu-Zhen Luo ◽  
...  
Keyword(s):  
Acute Phase ◽  
Mean Platelet Volume ◽  
Area Under The Curve ◽  
Small Vessel Vasculitis ◽  
Henoch Schonlein Purpura ◽  
Platelet Volume ◽  
Convalescent Phase ◽  
Schonlein Purpura ◽  
Henoch Schönlein Purpura

Background Henoch-Schonlein purpura is a systemic small-vessel vasculitis that occurs mainly in children. A review of the literature has suggested a correlation between mean platelet volume and several inflammatory disorders. However, to the best of our knowledge, any potential correlation between mean platelet volume and Henoch-Schonlein purpura has not been reported in the literature. Therefore, our study aimed to evaluate the role of mean platelet volume concentrations in patients with Henoch-Schonlein purpura. Methods This study included 97 children with Henoch-Schonlein purpura and 120 healthy individuals as controls. Results Mean platelet volume concentrations were found to be significantly lower in Henoch-Schonlein purpura patients compared with healthy controls (8.1 ± 0.86 vs. 9.4 ± 0.81, P < 0.001). Similarly, significant negative correlations were observed between mean platelet volume and neutrophil count, platelet count and erythrocyte sedimentation rate in patients with Henoch-Schonlein purpura (r=−0.327, P = 0.001; r=−0.419, P < 0.001; r=−0.255, P = 0.012). Interestingly, mean platelet volume was significantly lower in the acute phase compared with the convalescent phase of Henoch-Schonlein purpura patients (7.8 ± 0.86 vs. 8.3 ± 0.77, P = 0.002). A cut-off value for mean platelet volume was 7.85 with area under the curve of 0.726 to identify acute phase vs. convalescent phase in patients with Henoch-Schonlein purpura. Mean platelet volume was independently associated with Henoch-Schonlein purpura in logistic regression analysis (odds ratio = 0.114, 95% confidence interval = 0.053–0.243, P < 0.001). Conclusions Our results suggest that mean platelet volume is inversely associated with disease in patients with Henoch-Schonlein purpura, and mean platelet volume may be a useful marker to identify active disease in Henoch-Schonlein purpura patients.

scholarly journals Case of Gut Necrosis in Adult-Onset Immunoglobulin A Vasculitis (Henoch-Schönlein Purpura)

2020 ◽  
Vol 8 ◽  
pp. 232470962092556 ◽  
Author(s):  
Amanda S. Weissman ◽  
Viral Sanjay Patel ◽  
Omar Mushfiq
Keyword(s):  
Abdominal Pain ◽  
Renal Disease ◽  
Renal Involvement ◽  
Immunoglobulin A ◽  
Glucocorticoid Therapy ◽  
Acute Glomerulonephritis ◽  
Henoch Schonlein Purpura ◽  
Schonlein Purpura ◽  
Immunoglobulin A Vasculitis ◽  
Henoch Schönlein Purpura

Immunoglobulin A vasculitis (IgAV), formerly known as Henoch-Schönlein purpura, is an immune-mediated small vessel vasculitis characterized by palpable purpura, arthralgia, abdominal pain, and renal disease. It is primarily a childhood disease and usually resolves spontaneously with supportive therapy. Treatment of IgAV in adults is controversial with no clearly established guidelines. We report a rare case of IgAV in an adult male who developed gut necrosis and perforation while receiving glucocorticoid therapy for treatment of acute glomerulonephritis. A 44-year-old male was admitted with joint pain, leg swelling, mild abdominal pain, and a diffuse rash. Laboratory values revealed acute kidney injury with significant proteinuria and hematuria. The patient was started on glucocorticoid therapy for suspected IgAV nephritis, which was confirmed by kidney biopsy. Several days later, he complained of worsening abdominal pain. Imaging demonstrated bowel ischemia and perforation requiring multiple abdominal surgeries. The patient was critically ill in the intensive care unit with worsening renal failure requiring dialysis. He was discharged a month later after gradual recovery with stable but moderately impaired kidney function. IgAV is less common in adults; however, the disease is more severe with a higher risk of long-term complications. Adult patients with renal involvement may benefit from glucocorticoid therapy in preventing progression to end-stage renal disease. However, glucocorticoids may mask the symptoms of abdominal complications like gut necrosis and perforation causing delay in diagnosis and treatment. Therefore, vigilance to detect early signs of gut ischemia is imperative when treating an adult case of IgAV nephritis with glucocorticoids.

scholarly journals Clinical Characteristics and Risk Factors of Gastrointestinal Perforation in Children with Henoch-Schönlein Purpura

2020 ◽  
Author(s):  
Qingyin Guo ◽  
Xiaolei Hu ◽  
Chundong Song ◽  
Xianqing Ren ◽  
Wensheng Zhai ◽  
...  
Keyword(s):  
Risk Factors ◽  
Abdominal Pain ◽  
Intestinal Perforation ◽  
Renal Damage ◽  
Gastrointestinal Perforation ◽  
Small Vessel Vasculitis ◽  
Control Group ◽  
Henoch Schonlein Purpura ◽  
Schonlein Purpura ◽  
Henoch Schönlein Purpura

Abstract Background: Henoch-Schönlein purpura (HSP) is a common small vessel vasculitis in children. Gastrointestinal perforation (GP) rarely presents as a complication of HSP and was not well characterized. This study aimed to investigate the clinical features, diagnosis and risk factors of GP in children with HSP. Methods: We retrospectively reviewed the clinical data of 10791 children with HSP who attended our hospital between January 2014 and June 2018 and analyzed the treatment and clinical risk factors of 11 children with HSP complication with GP. Results: GP occurred in 11 children with HSP, with an incidence of 0.10%. Among the 11 cases HSP with GP, 1 case was gastric perforation and 10 cases were intestinal perforation. CT indicates perforation but ultrasonography did not indicate perforation in 5 cases of GP patients. The average duration of abdominal pain in HSP with GP was 9.3 days, and 9 cases (81.8%) with a duration of abdominal pain over 7 days. 3 cases of HSP with GP were treated by gastric/intestinal perforation repair and the other 8 cases were treated by enterectomy. The type of purpura, abdominal pain lasting more than 7 days, hematochezia, renal damage, and methylprednisolone dose more than 2mg/kg in GP with HSP patients show statistically significant compared with the control group (P<0.05). Conclusion: The incidence rate of GP in children with HSP was 0.10%. Abdominal (or mixed) HSP, hematochezia, renal damage, abdominal pain lasting more than 7 days, and methylprednisolone dose more than 2mg/kg may increase the risk of GP in children with HSP. CT has a high sensitivity for the diagnosis of GP. Early diagnosis and timely treatment of HSP with GP were very important for good clinical outcomes.

scholarly journals Henoch-Schonlein purpura associated with HLA-B27 positive axial spondyloarthritis in a young man

2019 ◽  
Vol 12 (5) ◽  
pp. e228881 ◽  
Author(s):  
Kevin John John ◽  
Mohammad Sadiq ◽  
Meera Thomas ◽  
Vijay Prakash Turaka
Keyword(s):  
Axial Spondyloarthritis ◽  
Case Reports ◽  
Lower Limbs ◽  
Small Vessel ◽  
Small Vessel Vasculitis ◽  
Hla B27 ◽  
Henoch Schonlein Purpura ◽  
Seronegative Spondyloarthropathies ◽  
Schonlein Purpura ◽  
Henoch Schönlein Purpura

Axial spondyloarthropathies are characterised by bilateral sacroiliitis, asymmetric oligoarthritis, association with the human leucocyte antigen (HLA)-B27, enthesitis and dactylitis. Although IgA nephropathy has a well-documented association with seronegative spondyloarthropathies, the association with Henoch-Schonlein purpura (HSP) has been documented only in few case reports. The present case is that of a 26-year-old man who presented with fever, lower limb arthritis, abdominal pain, palpable purpura over the buttocks and lower limbs, and clinical features of sacroiliitis. His blood tests showed elevated inflammatory markers and rheumatoid factor was negative. CT scan of the sacroiliac joints confirmed sacroiliitis. Skin biopsy revealed neutrophilic small vessel vasculitis. HLA-B27 was positive in blood. A diagnosis of HSP with HLA-B27 positive axial spondyloarthritis was made. HSP can be associated with HLA-B27 positive axial spondyloarthritis and has to be considered while evaluating for causes of cutaneous small vessel vasculitis in such patients.

scholarly journals Henoch-Schonlein Purpura Successfully Treated with Dexamethasone: A Case Report of Six-Year-Old Female

2017 ◽  
Vol 2 (1) ◽  
pp. e000095
Author(s):  
Purushottam Adhikari
Keyword(s):  
Abdominal Pain ◽  
Blood Test ◽  
Occult Blood ◽  
Small Vessel Vasculitis ◽  
Occult Blood Test ◽  
Henoch Schonlein Purpura ◽  
Common Causes ◽  
Schonlein Purpura ◽  
Multiple Episodes ◽  
Henoch Schönlein Purpura

Henoch-Schonlein Purpura (HSP) is one of the most common causes of small vessel vasculitis in children.  A six-year-old female presented with abdominal pain, swelling and rashes over both the legs associated with multiple episodes of vomiting for around ten days. Stool for the occult blood test was positive but there was an absence of hematuria and albuminuria. The case was diagnosed as HSP and treated with dexamethasone for ten days. The patient was finally discharged on the resolution of her symptoms.  Early diagnosis and treatment favor the better outcome in cases without any renal complications. Keywords: Henoch-Schönlein Purpura, Vasculitis, Steroids, Dexamethasone.

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