Henoch-Schonlein purpura: the Chandigarh experience.

ABSTRACT

OBJECTIVE: To determine the clinical profile of children with Henoch-Schonlein purpura (HSP). DESIGN: Hospital based descriptive follow-up study. SUBJECTS: 45 patients attending the Pediatric Rheumatology and Immunology clinic over the last 4 years. RESULTS: The patients were aged between 2.5-12 years with a male to female ratio of 21. All cases had palpable purpura. Gastrointestinal involvement was seen in 38 patients, with abdominal pain in 35 (78%) and lower GI bleed in 21 (47%). Large joint arthritis occurred in 60%. Renal involvement was seen in 14 subjects (31%). Major renal involvement occurred in 9 patients, with nephritic syndrome in 6 and nephrotic syndrome in 3 cases. Five patients had minor urinary abnormalities; 6 patients with major renal involvement and crescentic glomerulonephritis were treated with high dose pulse steroid therapy followed by oral prednisolone and azathioprine for 12-18 months. Normalization of urinary abnormalities occurred in these patients over 4-8 months and presently all are normotensive and off antihypertensive drugs. CONCLUSIONS: HSP in children is a common form of vasculitis. Though short term results in HSP nephritis have been good, long term prognosis in those with major renal involvement would remain guarded.