ABSTRACT
A descriptive study of one hundred and five Henoch-Schonlein purpura (HSP) patients (57 males, 48 females) treated during 1987-2003 in Department of Pediatrics, Faculty of Medicine Siriraj Hospital, was conducted. The male to female ratio was 1.2:1. The mean age of the patients was 7.1 years (range 2-15). Most patients lived in Bangkok and the central region of Thailand. HSP most commonly occurs in the rainy season. Clinical manifestations were rash (100%), arthralgia (61.9%), arthritis (25.7%), abdominal pain (66.7%), gastrointestinal bleeding (14.3%: stool occult blood 11.4% and hematemesis or melena 2.9%), nephritis (37.1%: microscopic hematuria 29.5%, gross hematuria 7.6%), proteinuria (23.8%), nephritic syndrome (1%), and hypertension (1%). The most characteristic rash was purpura, mainly on the lower extremities. Arthritis and/or arthralgia commonly affected feet ad ankles. The abdominal pain was commonly localized at epigastrium and umbilical area. Gastrointestinal complications included upper gastrointestinal bleeding, 34.3% developed recurrent symptoms including abdominal pain, nephritis, and rash mostly occurring within the first 3 months after the initial resolution (range 2 days-9.6 years). The mainstay of management was supportive care. The patients with severe abdominal pain received prednisolone. Prednisolone and cyclophosphamide were only given to serve nephritis patient with a good outcome.