Outcome of Henoch–Schönlein purpura 8 years after treatment with a placebo or prednisone at disease onset

Jauhola, Outi; Ronkainen, Jaana; Koskimies, Olli; Ala‐Houhala, Marja; Arikoski, Pekka; Hölttä, Tuula; Jahnukainen, Timo; Rajantie, Jukka; Örmälä, Timo; Nuutinen, Matti

doi:10.1007/s00467-012-2106-z

Cited by 46 publications

(30 citation statements)

References 34 publications

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“…20 Early prednisone treatment does not affect the outcome and was not be routinely used in several studies similar to our series. 21,22 Randomised controlled trials have found no statistically significant relationship between early prednisone treatment and a decrease in abdominal complications, namely hospitalization, intussusception, or surgery. [23][24][25] Central nervous system involvement is rare in the disease and was absent in our study.…”

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confidence: 99%

Clinical profile and outcome of Henoch Schonlein purpura in a tertiary care hospital in South India

Abbas

Geetha

Deepthi

et al. 2017

Int J Contemp Pediatr

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Background: Henoch Schonlein purpura (HSP) is the most common systemic vasculitis in children. It is an immunoglobulin A (IgA) mediated systemic small-vessel vasculitis, with IgA deposition in vessel walls leading to symptoms involving the skin, joints, intestines, and kidneys. The objective of present study was to identify and describe the clinical profile, pattern of joint involvement, histopathological features, treatment modalities and complications of Henoch Schonlein purpura.Methods: 52 children less than 12 years diagnosed to have Henoch Schonlein Purpura according to the European League against Rheumatism criteria were included in the study. All patients were subjected to detailed history taking and thorough examination. The clinical features, investigations, management and complications of the disease were studied. Descriptive statistics was used to analyse the results.Results: The common clinical features were palpable purpura (100%) followed by arthritis (66%) and abdominal pain (50%). Renal manifestations were in the form of hematuria in 12% of the patients. Skin biopsy was done in 25 patients of which 19 had findings suggestive of Henoch Schonlein purpura. Steroids were used in 42% of patients. The severity of illness was associated with lower mean age, arthritis, leg edema and stool occult blood.Conclusions: The clinical features of Henoch Schonlein purpura in the population were different from the previously published studies. Renal involvement was less common. The short-term outcome of the patients were satisfactory.

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confidence: 99%

Clinical profile and outcome of Henoch Schonlein purpura in a tertiary care hospital in South India

Abbas

Geetha

Deepthi

et al. 2017

Int J Contemp Pediatr

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“…2 Extrarenal symptoms typically resolve rapidly without complications, and the longterm prognosis of HSP mainly depends on the severity of renal involvement, termed Henoch-Scho¨nlein purpura nephritis (HSPN). 3,4 Renal manifestations vary from microhaematuria and minimal proteinuria to nephrotic syndrome; the proportion of patients with renal involvement also varies widely, with incidences ranging between 20 and 56% reported in different studies. 5 Although most patients with HSPN experience mild and self-limiting renal disease, 6 up to 20% of children with HSPN will develop chronic kidney disease, with up to 2% progressing to end-stage renal disease.…”

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confidence: 99%

Henoch–Schönlein purpura in 535 Chinese children: clinical features and risk factors for renal involvement

et al. 2014

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Objectives: To analyse the clinical features of Henoch-Schönlein purpura (HSP) with or without nephritis in Chinese children and to determine the risk factors for renal involvement. Methods: Patient characteristics, clinical parameters and laboratory data were retrospectively analysed in patients with HSP with or without nephritis. Logistic regression analysis was used to identify the risk factors for renal involvement. Results: A total of 535 patients with HSP were included in the study. HSP nephritis occurred in 267 patients (49.9%), ranging from isolated haematuria in 5.2%, mild proteinuria in 77.5%, moderate proteinuria in 6.4% and severe proteinuria in 10.9% of cases. In 90% of the cases, nephritis developed within 1 week of HSP onset; 98.5% of the cases with nephritis developed the condition within 1 month. Risk factors for the development of nephritis were age !6 years, purpura on sites other than the lower limbs and the presence of occult blood in the stool. Conclusion: These results suggest that patients aged !6 years, or who have purpura on the upper limbs or face, or who have occult blood in the stool should be particularly monitored for signs of nephritis.

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“…The only RCTs performed in HSP with oral prednisone were aimed at testing its possible role in the prevention of nephritis [17,18], and the results were negative [17][18][19]. To date, no placebo-controlled RCT on oral prednisone alone or methylprednisolone (MP) pulses associated with oral prednisone in established HSPN has been performed.…”

Section: Comment On the Use Of Steroidsmentioning

confidence: 99%

Pitfalls in recommending evidence-based guidelines for a protean disease like Henoch–Schönlein purpura nephritis

Davin

Coppo

2013

Pediatr Nephrol

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Outcome of Henoch–Schönlein purpura 8 years after treatment with a placebo or prednisone at disease onset

Cited by 46 publications

References 34 publications

Clinical profile and outcome of Henoch Schonlein purpura in a tertiary care hospital in South India

Clinical profile and outcome of Henoch Schonlein purpura in a tertiary care hospital in South India

Henoch–Schönlein purpura in 535 Chinese children: clinical features and risk factors for renal involvement

Pitfalls in recommending evidence-based guidelines for a protean disease like Henoch–Schönlein purpura nephritis

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