Henoch-Schönlein Purpura: What to expect

• Autor(a) principal: Gaia,Maria João
• Data de Publicação: 2019
• Outros Autores: Capela,Mariana, Borges,Joana Pires, Marques,Eduarda, Ferreira,Graça, Vinhas da Silva,António
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: http://scielo.pt/scielo.php?script=sci_arttext&pid=S0872-01692019000400004
• topic: Corticosteroids; Henoch-Schönlein; Purpura; Vasculitis

Introduction: Henoch-Schönlein Purpura is the most common systemic small vessel vasculitis of childhood. It is most frequently a selflimited entity, although some cases with concomitant nephritis may have serious complications. This study aims to analyze the clinical, epidemiologic and prognostic factors of children with this disease. Methods: Observational and retrospective study of children with diagnosis of Henoch-Schönlein Purpura from January 2011 to June 2017. Results: 61 patients were identified, with a median age of 6 years and a slight predominance of females. Purpura was present in all cases; the second most common symptom was arthralgia (75.4%), followed by gastrointestinal (39.3%), renal (31.1%) and scrotal involvement (6.6%). Corticotherapy was used in 12 patients (19.7%). Almost one fourth of the patients had a recurrence, but only 4 had persistent manifestations for longer than 6 months. Abdominal symptoms were found to have a positive correlation with renal involvement and corticotherapy showed no protective long-term effects. Discussion: Henoch-Schönlein Purpura is mostly a self-limited pathology. We found no association between age or sex and a poorer outcome, but a correlation between abdominal and renal involvement was found. We found a negative correlation between joint involvement and recurring episodes, showing that it may be a good prognostics factor. Corticotherapy demonstrated no protective long-term effect, and was on the contrary correlated with hospitalization, recurrence and persistence of signs and/or symptoms. This correlation can be explained by the fact that patients having indication for and receiving corticotherapy had an inherently more severe spectrum of the disease and so were more prone to poorer outcomes.