Henoch-Schonlein Purpura : Clinical Manifestations and Long-Term Outcomes in Thai Children

WASUTHIDA PABUNRUANG, M.D.*, SUPORN TREEPONGKARUNA, M.D.*, KANCHANA TANGNARARATCHAKIT, M.D.*, AMORNSRI CHUNHARAS, M.D.*, PORNPIMON PHUAPRADIT, M.D.*

Affiliation : *Department of Pediatric~, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.

AbstractThe clinical features of 47 children with Henoch-Schonlein purpura (HSP) are presented. The most common ages at presentation ranged from 3-5 years. Duration of data collection was 60 months. The peak incidence was from December to February. The organ involvements included skin (100%), gastrointestinal tract (74.5%), renal (46.8%) and joint (42.6%). Renal involvement was detected within the first 2 months in 16 cases (72.7%) but was delayed until 6 months after diagno sis in 6 cases. No risk factors for renal involvement could be identified. The mean duration of follow up was 2.6 years (range 1-5 years). Six out of 16 (37.5%) patients had residual renal diseases but none were end stage. Recurrent episodes of abdominal pain and skin purpura were found in a few cases during the first year. Overall prognosis of HSP is good and long-term morbidity is predominantly associated with renal involvement. Patients with initially normal urinalysis should have sequential urinary examina tion at least for 6 months.

Keywords : Henoch-Schonlein Purpura, IgA Nephropathy, Nephrotic Syndrome, Proteinuria, Hyper tension

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