Comparative study of Henoch-Scholein purpura in adults and children / 中华风湿病学杂志

ABSTRACT

Objective To assess the possible differences of the clinical features and renal pathology between children and adults with Henoch Schoelein purpura (HSP),and the contribution of clinical and renal biopsy parameters to predict the disease outcome.Methods A retrospective study was performed in 156 patients with HSP.Patients younger than 16 years at disease onset were considered children,and those aged 16 years or over were considered adults.Results The male was more prevalent in both adults and children HSP groups (M∶F=1 5∶1).The previous drug treatment,and special food intake were more frequent among the adults ( P =0 03 and 0 009,respectively).Renal involvement,increased ESR and serum IgA levels were more frequent in adults,but vomiting and joint pain were more in children.The frequencies of previous upper respiratory tract infection (URTI),fever,abdominal pain,melena and nephrotic syndrome were similar in both groups.Multivariate analysis showed that age at the disease onset,URTI and abdominal pain were predictive for renal involvement (RR=7 8,4 1 and 4 6,respectively).There were no differences of the renal pathologic types between two groups.However,lesions other than glomeruli including tubular and interstitial involvement were more frequent in adults.The outcome was better in children after a mean follow up of 6 2 years.Renal disease was the main clinical manifestation in non complete remission (NCR) patients.The proteinuria and the other area lesions out of glomeruli predict the decreased remission rate (RR=5 3 and 6 7,respectively).Conclusion These results indicate that HSP is more serious and nephritis is more frequent in adults.Proteinuria and lesions other than glomeruli are the higher risk factors of NCR.