J Korean Med Sci.  2014 Feb;29(2):198-203. 10.3346/jkms.2014.29.2.198.

Differences in Clinical Manifestations and Outcomes between Adult and Child Patients with Henoch-Schonlein Purpura

• Kang Y
• Park JS
• Ha YJ
• Kang MI
• Park HJ
• Lee SW
• Lee SK
• Park YB

• KMID: 1789975
• DOI: http://doi.org/10.3346/jkms.2014.29.2.198

Abstract

We aimed to investigate differences in clinical manifestations and outcomes between adult and child patients with Henoch-Schonlein purpura (HSP), and to analyze the factors associated with poor prognosis for HSP nephritis. This retrospective 10-yr study enrolled 160 patients with HSP who visited Severance Hospital. Purpura was mostly detected in lower extremities, but purpura in upper extremities was more frequently observed in adults than children (41.7% vs 19.3%). Children had a greater frequency of arthralgia (55.4% vs 27.1%), while adults had a greater frequency of diarrhea (20% vs 1.6%). Anemia, elevated C-reactive protein, and level of IgA were more frequently observed in adults (25% vs 7.1%, 65.6% vs 38.4%, 26.3% vs 3.5%). Renal involvement in adults was more severe than in children (79.2% vs 30.4%). Chronic renal failure showed a significant difference in outcomes of HSP between adults (10.4%) and children (1.8%) after a follow up period of an average of 27 months. Furthermore, renal insufficiency at diagnosis was significantly related to the progression to chronic renal failure. Our results showed several differences in the clinical features of HSP between adults and children. Adults with HSP had a higher frequency of renal insufficiency and worse renal outcomes than children. Renal insufficiency at diagnosis might be of predictive value for the progression to chronic renal failure in HSP patients.

Keyword

Purpura, Henoch-Schonlein; Child; Adult; Outcome; Prognostic Factor

MeSH Terms

Adult
Aged
Aged, 80 and over
Arthralgia/epidemiology/etiology
C-Reactive Protein/analysis
Child
Child, Preschool
Diarrhea/epidemiology/etiology
Extremities/pathology
Female
Follow-Up Studies
Humans
Immunoglobulin A/blood
Immunosuppressive Agents/therapeutic use
Infant
Middle Aged
Odds Ratio
Prognosis
Purpura, Schoenlein-Henoch/complications/*diagnosis/drug therapy/*pathology
Renal Insufficiency/epidemiology/etiology
Retrospective Studies
Young Adult
C-Reactive Protein
Immunoglobulin A
Immunosuppressive Agents

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