The clinical and endoscopic features of abdominal type Henoch-Scho..nlein purpura in children / 临床儿科杂志

ABSTRACT

Objective To explore the clinical features, endoscopic changes, and histopathological features of abdominal type Henoch-Scho..nlein purpura (HSP) in children. Methods The clinical data of 151 children with HSP who had abdominal pain as the primary symptom from June 2011 to June 2016 were analyzed retrospectively. Results A total of 151 children with HSP, (87 males and 64 females) aged 4.8 - 11.5 years, were enrolled. All of them had abdominal pain. There were 100 cases of cutaneous purpura (66.22%), 72 cases of vomit (47.68%), 59 cases of haematemesis (39.07%), 44 cases of hematochezia (29.13%) and 8 cases of joint swelling and pain (5.29%). Peripheral blood leucocytes increased in 114 cases (75.49%), C-reactive protein increased in 48 cases (31.78%), and albumin decreased in 21 cases (13.90%). It indicated the localized thickening of the intestinal wall in 49 cases (32.45%) by B-ultrasound. Gastroscopy was performed in 96 cases and main findings were patchy hemorrhage and erythema (89 cases, 92.70%), erosion or ulcer accompanied by bleeding (68 cases, 70.83%), ecchymosis (37 cases, 38.54%) and hematoma like process (13 cases, 8.60%). The descendent duodenum was the most common and had the most serious lesions, followed by gastric antrum and duodenal bulb. Histopathology showed capillary inflammation in 37 cases, 10 of which were accompanied by Helicobacter pylori infection.Enteroscopy was performed in 55 cases and main findings were punctate hemorrhage and erythema (49 cases, 89.09%), and erosion or multiple ulcer with hemorrhage (27 cases, 49.09%). The terminal ileum was the most common and had the most serious lesions, followed by rectum. Conclusions The clinical features of abdominal type HSP in children are varied, and it often involves descendent duodenum and terminal ileum. Endoscopic examination is valuable for the diagnosis of abdominal type HSP in children.