Background and aims The Henoch-Schönlein Purpura (HSP) is the most common of small-vessel vasculitis in children, with an annual incidence of 20.4/100. 000 in <17 years. The pathogenesis is unknown, but exposure to various antigens (infectious agents, vaccines, drugs) is considered as a possible immune factor trigger.
Methods Retrospective descriptive study by review of medical records of patients diagnosed with HSP between 2002–2013, and followed in rheumatology consultations for at least 6 months.
Results 119 children with a mean age at diagnosis of 6.1 years (range 1–14 years) were controlled.
Symptoms, blood pressure and urine dipstick were recorded at baseline and monthly during six months.
A previous infectious process was observed in 43 cases (36%): 10 streptococcus, 1 EBV, 2 Mycoplasma, 2 adenovirus and one parvovirus.
Purple was the first clinical sign in 90%. Of extrarenal symptoms, arthralgia appeared in 40 (33.6%) patients during follow-up, affecting more frequently ankles and knees (84%). The scrotal oedema occurred in 4 children, 2 had oedema of scalp and one on the sacrum. The abdominal pain was present in 18 cases (15%), 6 with ultrasound suggestive of intestinal wall vasculitis. The isolated microscopic hematuria was seen in 18 cases (15%), presenting normal blood pressure, 3 of these patients developed nephropathy in the next 2 months.
After 6 months of evolution all symptoms were resolved, with persisting hematuria in cases of nephropathy.
Conclusions HSP is usually a self-limiting disease. The extrarenal symptoms usually resolve quickly, without complications, and long-term prognosis depends mainly on the severity of renal involvement.
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