Use of steroids in children with Henoch-Schonlein purpura and abdominal pain
| Citation | Study group | Study type | Outcome | Key results | Comments |
|---|---|---|---|---|---|
| Rosenblum (1987)2 | 43 patients with HSP and abdominal pain 25 (58%) given prednisone. 18 (42%) not given prednisone | Cohort? 3b | Resolution of pain at: | Steroid treated v non treated | Similar groups but no mention of the use of analgesia in these groups. No mention of length of follow-up, discharge/re-admission for pain Limited details of group. Age and sex distribution Prednisone given at 1–2 mg/kg/day. Route? Daily? A retrospective study. No blinding/randomisation |
| 24 h | <24 h 44% v 14% p = 0.02 | ||||
| 48 h | <48 h 65% v 45% p = NS | ||||
| 72 h | <72 h 75% v 75% p = NS | ||||
| Leung (2001)3 | Case reports of 2 patients (both aged 5) with HSP and abdominal pain treated with intravenous hydrocortisone | Case series 4 | Resolution of pain | Rapid and complete relief of abdominal pain within 10 minutes | 2 case reports Rapid relief but pain relapse at later date. Little mention of conventional analgesia |
| Lin et al (1998)4 | 27 children (6.7±0.5 y) with HSP and abdominal pain treated with corticosteroids | Retrospective study 4? | Resolution of pain | Resolution of pain in 2.4±0.2 days | English abstract only. Limited data |
| Reinehr et al (2000)5 | 101 children (mean 6 y) with HSP. 57 with severe pain or bleeding treated with steroids | Retrospective study | Resolution of pain | Steroid treated children: 77%—pain resolved in 24 h Non-steroid treated: persistent pain for 5 days (median), range 1–28 days | No side effects observed. 1 patient treated with steroids and 2 not treated developed intussusception |
| Gunasekaran et al (2000)6 | 4 children with confirmed duodenojejunitis and clinical manifestations of HSP without the typical rash | Case series | Resolution of pain | Marked improvement in pain in 48 h | Patients followed up for 3 years |
| Repeat endoscopic examination at 8–12 weeks | Normal | ||||
| Van den Broek et al (1995)7 | 4 year old with HSP treated with IV prednisone | Case report | Resolution of pain | Improvement in two days | Steroids started on day7 of illness |
| Surgical complications | Entero-enteral fistula and abscess | Surgical complications diagnosed on day 25 at laparotomy after steroids stopped on day 19 |