Child Kidney Dis.  2017 Oct;21(2):61-68. 10.3339/jkspn.2017.21.2.61.

Clinical Features and Prognosis of Henoch-Schönlein Purpura in Children and Adults: A 13-Year Retrospective Study at a Single Centre

• Jung DY
• Kwon YR
• Yu MH
• Namgoong M

• KMID: 2394441
• DOI: http://doi.org/10.3339/jkspn.2017.21.2.61

Abstract

PURPOSE
To investigate differences in clinical features, blood/urinary findings, and prognosis in different age groups of patients with Henoch-Schönlein purpura (HSP).
METHODS
A total of 469 patients with HSP were analyzed retrospectively from June 2003 to February 2016. We classified patients into child or adult groups based on their age.
RESULTS
The adult group had more patients with anemia (child vs. adult; 7.5% vs. 16.4%), and higher immunoglobulin A (IgA) (30.0% vs. 50.0%) levels, C-reactive protein (34.2% vs. 54.0%) and uric acid (3.1% vs. 12.1%) levels than the child group. The child group was highly positive for Mycoplasma pneumoniae immunoglobulin M (IgM) (34.4%). More patients in the child group presented with high levels of antistreptolysin O (24.7% vs. 2.9%) and high C4 (11.5% vs. 4.2%). Low C3 (1.1% vs. 10.2%) levels, and renal involvement with gross hematuria (8.6% vs. 21.5%), nonnephrotic proteinuria (1.1% vs. 11.2%), and nephrotic syndrome (1.1% vs. 6.0%) were common in the adult group. Adults also had poorer renal outcomes [persistent hematuria/proteinuria (10.5% vs. 32.8%), and chronic kidney disease (0% vs. 11.2%)] than the child group. Risk factors for renal involvement such as older age and higher level of uric acid were only found in the child group. The risk factors for poor renal outcome were nephrotic syndrome in the child group and gross hematuria in the adult group.
CONCLUSION
In this study, child and adult groups presented with different clinical manifestations of HSP. We found that risk factors for renal involvement included age and high uric acid level in the child group. Moreover, nephrotic syndrome in the child group and gross hematuria in the adult group increased the risk of poor renal outcome.

Keyword

Henoch-Schönlein Purpura; Children; Adult; Clinical feature; Prognosis

MeSH Terms

Adult*
Anemia
Antistreptolysin
C-Reactive Protein
Child*
Hematuria
Humans
Immunoglobulin A
Immunoglobulin M
Mycoplasma pneumoniae
Nephrotic Syndrome
Pneumonia, Mycoplasma
Prognosis*
Proteinuria
Purpura*
Renal Insufficiency, Chronic
Retrospective Studies*
Risk Factors
Uric Acid
Antistreptolysin
C-Reactive Protein
Immunoglobulin A
Immunoglobulin M
Uric Acid