Púrpura de Henoch-Schönlein: recorrência e cronicidade

• Autor(a) principal: Alfredo, Camila S. [UNIFESP]
• Data de Publicação: 2007
• Outros Autores: Nunes, Nicole Acacia Cabral [UNIFESP], Len, Claudio Arnaldo [UNIFESP], Barbosa, Cassia Maria Passarelli Lupoli [UNIFESP], Terreri, Maria Teresa Ramos Ascensão [UNIFESP], Hilário, Maria Odete Esteves [UNIFESP]
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Institucional da UNIFESP
• Texto Completo: http://dx.doi.org/10.1590/S0021-75572007000200013; http://repositorio.unifesp.br/handle/11600/3623
• topic: Henoch-Schönlein purpura; purpura; nephritis; vasculitis; Púrpura de Henoch-Schönlein; púrpura; nefrite; vasculite

OBJECTIVES: To describe a group of patients treated at our service for Henoch-Schönlein purpura, with emphasis on recurrent and chronic cases, and to compare clinical and demographic characteristics of patients with monocyclic and recurrent disease. METHODS: Data on 67 patients who had been treated since disease onset were analyzed. Twelve patients were excluded because they failed to return for follow-up consultations after less than 3 months, leaving a total of 55 children in the study sample. Recurrence was defined as the presence of a fresh episode after a period of at least 3 months without symptoms, and cases were defined as chronic when cutaneous, abdominal and renal manifestations persisted for a period of 12 months or more. RESULTS: Recurrence was observed in 8/55 patients (14.4%) and four cases were chronic (7.2%). In 29/55 patients (52.7%), infection was identified as the trigger factor. A monocyclic clinical course was observed in 43 patients (26 of whom were girls, with a mean age of 5.4 years). Gastrointestinal and renal involvement was observed in 55.8 and 20.9% of patients, respectively. Among the 12 patients with recurrent or chronic Henoch-Schönlein purpura, three had arthritis, four exhibited signs and symptoms of abdominal involvement and seven of kidney disease: microscopic hematuria in five, macroscopic hematuria in one and hematuria with proteinuria in one other. Late onset was the only variable related to recurrence (p < 0.05). CONCLUSIONS: As is observed in medical literature, monocyclic cases are more common among children with early onset disease. Patients with Henoch-Schönlein purpura should be followed over the long term, since recurrent and chronic cases account for more than 20% of the total.