Henoch-Schönlein Purpura in Northern Spain

Abstract

The severity of clinical features and the outcomes in previous series of patients reported with Henoch-Schönlein purpura (HSP) vary greatly, probably due to selection bias. To establish the actual clinical spectrum of HSP in all age groups using an unselected and wide series of patients diagnosed at a single center, we performed a retrospective review of 417 patients classified as having HSP according to the criteria proposed by Michel et al. Of 417 patients, 240 were male and 177 female, with a median age at the time of disease diagnosis of 7.5 years (interquartile range [IQR], 5.3–20.1 yr). Three-quarters of the patients were children or young people aged 20 years or younger (n = 315), and one-quarter were adults (n = 102). The most frequent precipitating events were a previous infection (38%), usually an upper respiratory tract infection, and/or drug intake (18.5%) shortly before the onset of the vasculitis. At disease onset the most common manifestations were skin lesions (55.9%), nephropathy (24%), gastrointestinal involvement (13.7%), joint symptoms (9.1%), and fever (6.2%). Cutaneous involvement occurring in all patients, mainly purpuric skin lesion, was the most common manifestation when the vasculitis was fully established, followed by gastrointestinal (64.5%), joint (63.1%), and renal involvement (41.2%). The main laboratory findings were leukocytosis (36.7%), anemia (8.9%), and increased serum IgA levels (31.7%). The most frequent therapies used were corticosteroids (35%), nonsteroidal antiinflammatory drugs (14%), and cytotoxic agents (5%). After a median follow-up of 12 months (IQR, 2–38 mo), complete recovery was observed in most cases (n = 346; 83.2%), while persistent, usually mild, nephropathy was observed in only 32 (7.7%) cases. Relapses were observed in almost a third of patients (n = 133; 31.9%).In conclusion, although HSP is a typical vasculitis affecting children and young people, it is not uncommon in adults. The prognosis is favorable in most cases, depending largely on renal involvement.

Insight into inflammatory cell and cytokine profiles in adult IgA vasculitis

“…Clinical signs and symptoms of the disease include cutaneous purpura, joint, gastrointestinal tract (GIT), and renal involvement; however, they differ greatly depending on the age of the patients [5,6]. Adults develop systemic involvement more frequently compared to children, with greater risk of severe bowel ischemia and chronic renal failure [7][8][9][10][11].…”

Unusual Eruptions Associated with <b><i>Mycoplasma pneumoniae</i></b> Respiratory Infections: Review of the Literature

“…We found 14 case series addressing Henoch-Schönlein syndrome in a total of 2,186 cases published in English-language journals between 1984 and 2014 [63,64,65,66,67,68,69,70,71,72,73,74,75,76]. None of the reports included cases associated with M. pneumoniae respiratory infection.…”

“…Using the described strategy, 94 reports were retained for the final analysis [4,5,6,7,8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69,70,71,72,73,74,75,76,77,78,79,80,81,82,83,84,85,86,87,88,89,90,91,92,93,94,95,96,97]: 1 in German [23], 1 in Italian […”

Púrpura de Schönlein-Henoch con afectación peniana. Caso clinico

“…3 En una serie de 417 pacientes con PSH presentada por Calvo-Río et al, que incluyó a niños y adultos, ninguno presentó afectación en el pene. 2 En una reciente publicación de Paydary et al, de los 168 pacientes ingresados por PSH, 100 eran varones y solamente 9 de estos casos presentaron afectación peniana. 4 El diagnóstico de la afectación peniana en pacientes con exantema purpúrico concomitante es relativamente sencillo.…”

“…Se han descrito otras formas de presentación más infrecuentes que pueden afectar al escroto, al sistema nervioso central y periférico, al tracto respiratorio y a los ojos. 2 La afectación peniana, por su parte, es excepcional y son muy pocos los casos descritos en la literatura, lo que da lugar a un escaso conocimiento del tratamiento y evolución de esta inusual forma de presentación de la PSH. …”