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ORIGINAL ARTICLE
Korean J Pediatr 2005 November;48(11) :1244-1251.
Different Clinical Courses of Henoch-Sch nlein Purpura in Children, Adolescents and Adults
Joo Hee Hong (Hong JH)1, Hyung Joon Na (Na HJ)1, Mee Kyung Namgoong (Namgoong MK)1, Seung Ok Choi (Choi SO)2, Byng Geun Han (Han BG)2, Soon Hee Jung (Jung SH)3, Hwang Min Kim (Kim HM)1
2Department of Internal Medicine, Wonju College of Medicine, Yonsei University, Wonju, Korea
3Department of Pathology, Wonju College of Medicine, Yonsei University, Wonju, Korea
Corresponding Author: Hwang Min Kim ,Email: hmk9210@wonju.yonsei.ac.kr
Copyright © 2005 by The Korean Pediatric Society
ABSTRACT
Purpose : Henoch-Sch nlein purpura(HSP) is the most common and benign systemic vasculitis in children. Few reports have focused on worse outcomes of HSP in adults. The age of onset is suggested as a main risk factor. We assessed the characteristics of adolescent-onset HSP. Methods : We retrospectively analyzed 205 cases presented from Aug. 1993 to Oct. 2003. Patients were classified as children(<10 years of age), adolescents(10-20 years of age), and adults(>20 years of age). Results : The mean age was 5.7?.8 years in 149 children, 13.5?.4 years in 38 adolescents, and 44.9?4.5 years in 18 adults. The male to female ratio was 1.2 : 1 in children and adolescents, and 2 : 1 in adults. Previous upper respiratory infections were found in 53.4 percent of children, 32.4 percent of adolescents, and 33.3 percent of adults. Positivity of stool occult blood was more frequent in adults(50.5 percent) than in children(23.0 percent)(P<0.05). Renal involvement was found in 46 cases (30.9 percent) of children, 23 cases(60.5 percent) of adolescents, and 15 cases(83.3 percent) of adults. Recurrences occurred in 23 cases(15.4 percent) of children, nine cases(23.7 percent) of adolescents, and three cases(16.7 percent) of adults. Among the cases with renal involvement, 97.8 percent of children and 87.0 percent of adolescents improved to normal or asymptomatic urinary abnormalities. 60.0 percent of adults persisted with severe nephropathy and 13.3 percent progressed to renal insufficiency. Conclusion : Although the outcome of adolescent HSP was as good as children, the clinical manifestations were similar to those of adults. Adolescents had the highest rate of recurrences. Thus long term observations may be needed in adolescent onset HSP.
Keywords: Henoch-Sch nlein purpura | Children | Adolescents | Adults
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