Fifteen-year experience of children with Henoch-Schönlein purpura in southern Taiwan, 1991-2005.

BACKGROUND AND PURPOSE: Although Henoch-Schönlein purpura (HSP) is the most common cause of systemic vasculitis in children, long-term and large-scale Taiwanese studies on HSP are rare. We reviewed the records of 107 Taiwanese pediatric patients diagnosed with HSP at our institution between 1991 and 2005.

METHODS: The first clinical manifestations, laboratory findings, and outcome evaluations of the patients were analyzed. Data were grouped according to the presence of fever and upper respiratory tact infection (URI) as a presenting symptom and also by gender. Chi-squared test was used for statistical analysis.

RESULTS: The children had a mean age of 6.2 +/- 2.5 years (range, 2 to 13 years), with a male-to-female ratio of 1.0:0.7. Main clinical symptoms included skin rashes (95.3%), gastrointestinal (GI) symptoms (72.0%), joint involvement (46.7%), and kidney involvement (28.0%). The most common first manifestations were skin rashes (56.1%), GI symptoms (35.5%), and joint involvement (12.1%). There was no significant association between first manifestations and fever presence or gender. However, the non-URI patients had a significantly higher incidence of GI problems than the URI group (p=0.01). Fever as a symptom was not associated with elevation of C-reactive protein (p=0.45). Immunoglobulin A levels were within the normal range. No chronic renal failure or end-stage renal disease was detected, and overall the prognosis of patients was good.

CONCLUSIONS: The categories used did not predict the expression of HSP, with the exception of an association between absence of URI and GI manifestations. Overall, HSP showed a good prognosis.