IgA Vasküliti (Henoch-Schönlein Purpurası) Olan Pediatrik Hastaların Epidemiyolojik, Klinik ve Laboratuvar Bulgularının Değerlendirilmesi
Öz
ÖZ:
Amaç: IgA vasküliti (Henoch-Schönlein purpurası) çocukluk çağının en sık görülen sistemik vasküliti olup deri, eklemler, gastrointestinal sistem ve böbrekleri tutar ve daha az sıklıkla diğer sistemleri etkiler. Bu çalışmada, IgA vaskülitli çocuk hastaların epidemiyolojik, klinik ve laboratuvar bulgularını değerlendirmeyi amaçladık.
Gereç ve Yöntem: Bu çalışmada, pediatrik nefroloji kliniğinde IgA vasküliti tanısı alan 366 hasta retrospektif olarak analiz edildi. Demografik özellikler, klinik bulgular, sistem tutulumu ve laboratuvar bulguları kaydedildi.
Bulgular: Çalışmaya katılan hastaların %57,9'u (212) erkekti ve erkek/kadın oranı 1,37 idi. En sık görülen yaş grubu 5-9 yaş arası olarak saptandı. Yaş ile böbrek tutulumu arasında istatistiksel olarak anlamlı bir korelasyon vardı (p<0.001). Yaş arttıkça böbrek tutulumunun arttığı saptandı. Gastrointestinal sistem tutulumu erkek cinsiyette istatistiksel olarak anlamlı derecede yüksekti (p=0.003). Lökosit sayısındaki artış ile gastrointestinal sistem tutulumu ve böbrek tutulumu arasında istatistiksel olarak anlamlı bir korelasyon vardı (sırasıyla p=0.001, p=0.009).
Sonuç: Yaş ve artmış lökosit sayısı böbrek tutulumu için risk faktörü olarak bulunmuştur. Erkek cinsiyet ve artmış lökosit sayısı gastrointestinal sistem tutulumu için risk faktörü olarak bulunmuştur.
Anahtar Kelimeler
IgA vasküliti Henoch-Schönlein Purpurası Çocuk Renal tutulum Gastrointestinal tutulum
Kaynakça
- Leung AKC, Barankin B, Leong KF. Henoch-Schönlein Purpura in Children: An Updated Review. Curr Pediatr Rev 2020;16:265-76.
- Roberts PF, Waller TA, Brinker TM, Riffe IZ, Sayre JW, Bratton RL. Henoch-Schönlein purpura: a review article. South Med J 2007;100:821-4.
- Rostoker G. Schönlein-henoch purpura in children and adults: diagnosis, pathophysiology and management. BioDrugs 2001;15:99-138.
- Ozen S, Pistorio A, Iusan SM, Bakkaloglu A, Herlin T, Brik R, et al. EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis 2010;69:798-806.
- Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int 2012;Suppl 2:1-138.
- Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 2013;65:1-11.
- Di Pietro GM, Castellazzi ML, Mastrangelo A, Montini G, Marchisio P, Tagliabue C. Henoch-Schönlein Purpura in children: not only kidney but also lung. Pediatr Rheumatol Online J 2019;17:75.
- Dedeoglu F, Sundel RP. Vasculitis in children. Pediatr Clin North Am 2005;52:547-75, vii.
- Yang YH, Huang MT, Lin SC, Lin YT, Tsai MJ, Chiang BL. Increased transforming growth factor-beta (TGF-beta)-secreting T cells and IgA anti-cardiolipin antibody levels during acute stage of childhood Henoch-Schönlein purpura. Clin Exp Immunol 2000;122:285-90.
- Brogan P, Bagga A. Leukocytoclastic vasculitis. In Ross E.Petty, Ronald M. Laser, Carol B., Lindsley, Lucy R. Wedderburn. Textbook of Pediatric Rheumatology 2016;(7th ed): 452–460.
- Karadağ ŞG, Tanatar A, Sönmez HE, Çakmak F, Kıyak A, Yavuz S, et al. The clinical spectrum of Henoch-Schönlein purpura in children: a single-center study. Clin Rheumatol 2019;38:1707-14.
- Piram M, Maldini C, Biscardi S, De Suremain N, Orzechowski C, Georget E, et al. Incidence of IgA vasculitis in children estimated by four-source capture-recapture analysis: a population-based study. Rheumatology (Oxford) 2017;56:1358-66.
- Lucas García J, Alvarez Blanco O, Sanahuja Ibáñez MJ, Ortega López PJ, Zamora Martín I. Evolución de la nefropatía de Schönlein-Henoch en pacientes pediátricos. Factores pronósticos [Outcome of Henoch-Schönlein nephropathy in pediatric patients. Prognostic factors]. Nefrologia 2008;28:627-32.
- Hwang HH, Lim IS, Choi BS, Yi DY. Analysis of seasonal tendencies in pediatric Henoch-Schönlein purpura and comparison with outbreak of infectious diseases. Medicine (Baltimore) 2018;97:e12217.
- Kasapçopur Ö, Arısoy N. Henoch- Schönlein Purpurası. Türk Pediatri Arşivi 2002;37:122-9.
- Fan GZ, Li RX, Jiang Q, Niu MM, Qiu Z, Chen WX ,et al. Streptococcal infection in childhood Henoch-Schönlein purpura: a 5-year retrospective study from a single tertiary medical center in China, 2015-2019. Pediatr Rheumatol Online J 2021;19:79.
- de Almeida JL, Campos LM, Paim LB, Leone C, Koch VH, Silva CA. Renal involvement in Henoch-Schönlein purpura: a multivariate analysis of initial prognostic factors. J Pediatr (Rio J) 2007;83:259-66.
- Makay B, Gücenmez ÖA, Duman M, Ünsal E. The relationship of neutrophil-to-lymphocyte ratio with gastrointestinal bleeding in Henoch-Schonlein purpura. Rheumatol Int 2014;34:1323-7.
- Buscatti IM, Casella BB, Aikawa NE, Watanabe A, Farhat SCL, Campos LMA, Silva CA. Henoch-Schönlein purpura nephritis: initial risk factors and outcomes in a Latin American tertiary center. Clin Rheumatol 2018;37:1319-24.
- Jauhola O, Ronkainen J, Koskimies O, Ala-Houhala M, Arikoski P, Hölttä T, et al. Renal manifestations of Henoch-Schonlein purpura in a 6-month prospective study of 223 children. Arch Dis Child 2010;95:877-82.
- Tabel Y, Inanc FC, Dogan DG, Elmas AT. Clinical features of children with Henoch-Schonlein purpura: risk factors associated with renal involvement. Iran J Kidney Dis 2012;6:269-74.
- Lim Y, Yi BH, Lee HK, Hong HS, Lee MH, Choi SY, Park JO. Henoch-Schonlein purpura: ultrasonography of scrotal and penile involvement. Ultrasonography 2015;34:144-7.
- Sherk HH. Commentaries on the history and cure of diseases. Digitorum Nodi by William Heberden MD. Clin Orthop Relat Res 2004;(427 Suppl):S3-4.
- Peru H, Soylemezoglu O, Bakkaloglu SA, Elmas S, Bozkaya D, Elmaci AM, Kara F, Buyan N, Hasanoglu E. Henoch Schonlein purpura in childhood: clinical analysis of 254 cases over a 3-year period. Clin Rheumatol 2008;27:1087-92.
- Rigante D, Candelli M, Federico G, Bartolozzi F, Porri MG, Stabile A. Predictive factors of renal involvement or relapsing disease in children with Henoch-Schönlein purpura. Rheumatol Int 2005;25:45-8.
- Makay B, Türkyilmaz Z, Duman M, Unsal E. Mean platelet volume in Henoch-Schönlein purpura: relationship to gastrointestinal bleeding. Clin Rheumatol 2009;28:1225-8.
- Ekinci RMK, Balci S, Sari Gokay S, Yilmaz HL, Dogruel D, Altintas DU, Yilmaz M. Do practical laboratory indices predict the outcomes of children with Henoch-Schönlein purpura? Postgrad Med 2019;131:295-8.
- Assadi F. Childhood Henoch-Schonlein nephritis: a multivariate analysis of clinical features and renal morphology at disease onset. Iran J Kidney Dis 2009;3:17-21.
- Uppal SS, Hussain MA, Al-Raqum HA, Nampoory MR, Al-Saeid K, Al-Assousi A, Abraham M, Malaviya AN. Henoch-Schönlein’s purpura in adults versus children/adolescents: A comparative study. Clin Exp Rheumatol 2006;24:S26-30.
Evaluation of Epidemiological, Clinical, and Laboratory Findings in Pediatric Patients with IgA Vasculitis (Henoch-Schönlein Purpura)
Öz
Objective: Immunoglobulin A vasculitis (Henoch-Schönlein Purpura) is the most common systemic vasculitis of childhood involving the skin, joints, gastrointestinal tract, and kidneys, and less frequently affects other systems. In this study, we aimed to evaluate the epidemiologic, clinical, and laboratory findings of pediatric patients with IgA vasculitis.
Material and Methods: In this study, 366 patients diagnosed with IgA vasculitis (Henoch-Schönlein Purpura) in the pediatric nephrology clinic were retrospectively analyzed. Demographic characteristics, clinical findings, system involvement, and laboratory findings were recorded.
Results: Of the patients in the study, 57.9% (212) were male and the male-to-female ratio was 1.37. The most common age group was found to be between 5-9 years of age. A statistically significant correlation existed between age and renal involvement (p<0.001). It was found that renal involvement increased with increasing age. Gastrointestinal system involvement was statistically significantly higher in the male gender (p=0.003). A statistically significant correlation existed between increased leukocyte counts, gastrointestinal system involvement, and renal involvement (p=0.001, p=0.009, respectively).
Conclusion: Age and increased leukocyte count were found to be risk factors for renal involvement. Male gender and increased leukocyte count were found to be risk factors for gastrointestinal system involvement.
Anahtar Kelimeler
IgA Vasculitis Henoch-Schönlein Purpura Child Renal involvement Gastrointestinal involvement
Kaynakça
- Leung AKC, Barankin B, Leong KF. Henoch-Schönlein Purpura in Children: An Updated Review. Curr Pediatr Rev 2020;16:265-76.
- Roberts PF, Waller TA, Brinker TM, Riffe IZ, Sayre JW, Bratton RL. Henoch-Schönlein purpura: a review article. South Med J 2007;100:821-4.
- Rostoker G. Schönlein-henoch purpura in children and adults: diagnosis, pathophysiology and management. BioDrugs 2001;15:99-138.
- Ozen S, Pistorio A, Iusan SM, Bakkaloglu A, Herlin T, Brik R, et al. EULAR/PRINTO/PRES criteria for Henoch-Schönlein purpura, childhood polyarteritis nodosa, childhood Wegener granulomatosis and childhood Takayasu arteritis: Ankara 2008. Part II: Final classification criteria. Ann Rheum Dis 2010;69:798-806.
- Kidney Disease: Improving Global Outcomes (KDIGO) Acute Kidney Injury Work Group. KDIGO clinical practice guideline for acute kidney injury. Kidney Int 2012;Suppl 2:1-138.
- Jennette JC, Falk RJ, Bacon PA, Basu N, Cid MC, Ferrario F, et al. 2012 revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. Arthritis Rheum 2013;65:1-11.
- Di Pietro GM, Castellazzi ML, Mastrangelo A, Montini G, Marchisio P, Tagliabue C. Henoch-Schönlein Purpura in children: not only kidney but also lung. Pediatr Rheumatol Online J 2019;17:75.
- Dedeoglu F, Sundel RP. Vasculitis in children. Pediatr Clin North Am 2005;52:547-75, vii.
- Yang YH, Huang MT, Lin SC, Lin YT, Tsai MJ, Chiang BL. Increased transforming growth factor-beta (TGF-beta)-secreting T cells and IgA anti-cardiolipin antibody levels during acute stage of childhood Henoch-Schönlein purpura. Clin Exp Immunol 2000;122:285-90.
- Brogan P, Bagga A. Leukocytoclastic vasculitis. In Ross E.Petty, Ronald M. Laser, Carol B., Lindsley, Lucy R. Wedderburn. Textbook of Pediatric Rheumatology 2016;(7th ed): 452–460.
- Karadağ ŞG, Tanatar A, Sönmez HE, Çakmak F, Kıyak A, Yavuz S, et al. The clinical spectrum of Henoch-Schönlein purpura in children: a single-center study. Clin Rheumatol 2019;38:1707-14.
- Piram M, Maldini C, Biscardi S, De Suremain N, Orzechowski C, Georget E, et al. Incidence of IgA vasculitis in children estimated by four-source capture-recapture analysis: a population-based study. Rheumatology (Oxford) 2017;56:1358-66.
- Lucas García J, Alvarez Blanco O, Sanahuja Ibáñez MJ, Ortega López PJ, Zamora Martín I. Evolución de la nefropatía de Schönlein-Henoch en pacientes pediátricos. Factores pronósticos [Outcome of Henoch-Schönlein nephropathy in pediatric patients. Prognostic factors]. Nefrologia 2008;28:627-32.
- Hwang HH, Lim IS, Choi BS, Yi DY. Analysis of seasonal tendencies in pediatric Henoch-Schönlein purpura and comparison with outbreak of infectious diseases. Medicine (Baltimore) 2018;97:e12217.
- Kasapçopur Ö, Arısoy N. Henoch- Schönlein Purpurası. Türk Pediatri Arşivi 2002;37:122-9.
- Fan GZ, Li RX, Jiang Q, Niu MM, Qiu Z, Chen WX ,et al. Streptococcal infection in childhood Henoch-Schönlein purpura: a 5-year retrospective study from a single tertiary medical center in China, 2015-2019. Pediatr Rheumatol Online J 2021;19:79.
- de Almeida JL, Campos LM, Paim LB, Leone C, Koch VH, Silva CA. Renal involvement in Henoch-Schönlein purpura: a multivariate analysis of initial prognostic factors. J Pediatr (Rio J) 2007;83:259-66.
- Makay B, Gücenmez ÖA, Duman M, Ünsal E. The relationship of neutrophil-to-lymphocyte ratio with gastrointestinal bleeding in Henoch-Schonlein purpura. Rheumatol Int 2014;34:1323-7.
- Buscatti IM, Casella BB, Aikawa NE, Watanabe A, Farhat SCL, Campos LMA, Silva CA. Henoch-Schönlein purpura nephritis: initial risk factors and outcomes in a Latin American tertiary center. Clin Rheumatol 2018;37:1319-24.
- Jauhola O, Ronkainen J, Koskimies O, Ala-Houhala M, Arikoski P, Hölttä T, et al. Renal manifestations of Henoch-Schonlein purpura in a 6-month prospective study of 223 children. Arch Dis Child 2010;95:877-82.
- Tabel Y, Inanc FC, Dogan DG, Elmas AT. Clinical features of children with Henoch-Schonlein purpura: risk factors associated with renal involvement. Iran J Kidney Dis 2012;6:269-74.
- Lim Y, Yi BH, Lee HK, Hong HS, Lee MH, Choi SY, Park JO. Henoch-Schonlein purpura: ultrasonography of scrotal and penile involvement. Ultrasonography 2015;34:144-7.
- Sherk HH. Commentaries on the history and cure of diseases. Digitorum Nodi by William Heberden MD. Clin Orthop Relat Res 2004;(427 Suppl):S3-4.
- Peru H, Soylemezoglu O, Bakkaloglu SA, Elmas S, Bozkaya D, Elmaci AM, Kara F, Buyan N, Hasanoglu E. Henoch Schonlein purpura in childhood: clinical analysis of 254 cases over a 3-year period. Clin Rheumatol 2008;27:1087-92.
- Rigante D, Candelli M, Federico G, Bartolozzi F, Porri MG, Stabile A. Predictive factors of renal involvement or relapsing disease in children with Henoch-Schönlein purpura. Rheumatol Int 2005;25:45-8.
- Makay B, Türkyilmaz Z, Duman M, Unsal E. Mean platelet volume in Henoch-Schönlein purpura: relationship to gastrointestinal bleeding. Clin Rheumatol 2009;28:1225-8.
- Ekinci RMK, Balci S, Sari Gokay S, Yilmaz HL, Dogruel D, Altintas DU, Yilmaz M. Do practical laboratory indices predict the outcomes of children with Henoch-Schönlein purpura? Postgrad Med 2019;131:295-8.
- Assadi F. Childhood Henoch-Schonlein nephritis: a multivariate analysis of clinical features and renal morphology at disease onset. Iran J Kidney Dis 2009;3:17-21.
- Uppal SS, Hussain MA, Al-Raqum HA, Nampoory MR, Al-Saeid K, Al-Assousi A, Abraham M, Malaviya AN. Henoch-Schönlein’s purpura in adults versus children/adolescents: A comparative study. Clin Exp Rheumatol 2006;24:S26-30.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Klinik Tıp Bilimleri (Diğer) |
| Bölüm | ORIGINAL ARTICLES |
| Yazarlar | |
| Erken Görünüm Tarihi | 4 Ocak 2024 |
| Yayımlanma Tarihi | 18 Mart 2024 |
| Gönderilme Tarihi | 10 Ekim 2023 |
| Kabul Tarihi | 28 Kasım 2023 |
| Yayımlandığı Sayı | Yıl 2024 Cilt: 18 Sayı: 2 |