Journal of the Korean Pediatric Society 2003;46(11):1118-1123.
Published online November 15, 2003.
A Clinical Study of Childhood Henoch-Sch nlein Purpura
Tae-Sun Ha1, Hyun-Hoe Koo1
1Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Korea
1Department of Pediatrics, College of Medicine, Chungbuk National University, Cheongju, Korea
Henoch-Sch nlein 자반증 환아의 임상적 고찰
하태선1, 구현희1
1충북대학교 의과대학 소아과학교실
1충북대학교 의과대학 소아과학교실
Correspondence: 
Tae-Sun Ha, Email: tsha@med.chungbuk.ac.kr
Abstract
Purpose
: Henoch-Sch nlein purpura(HSP) is a systemic vasculitis, characterized by cutaneous purpura, abdominal pain, arthralgia and renal involvement. The clinical features of HSP have been reasonably well documented but there are still many gaps in our understanding of HSP. The aim of this study was to present the clinical features of 125 children with HSP and compare them with previous reports, placing particular emphasis on clinical information.
Methods
: We collected the clinical data of 125 patients with acute HSP who visited Chungbuk National University Hospital from March 1992 to April 2002. Data were expressed as the mean or mean켚D and statistical analysis was performed using Chi-square approximation. P<0.05 was considered as significant.
Results
: The patient population consisted of 87 boys and 38 girls ranging in age from one to 14 years. HSP occurs throughout the year, but this study shows seasonal skewing, with most patients presenting from fall through spring and a paucity of cases in summer. All patients had non-thrombocytopenic purpura concentrated on the buttocks and lower extremities. Purpuric lesions were also scattered on the arms and occaisionally on the face and ears, but the trunk was largely spared. A recurrence of purpura was defined as the reappearance of a rash or other symptoms following resolution of disease for at least two weeks. The mean number of recurrences was 0.51. Eighty eight patients(70.4%), 18 patients(14.4%) and 67 patients(53.6%) complained of abdomianl pain, gastrointestinal bleeding and arthralgia, respectively. Nephritis occurred in 48(38.4%) patients. Fifteen boys (17.2%) developed epididymitis. Neurologic features occurred in 13(10.4%) and two(15%) of these were seizures.
Conclusion
: HSP all showing purpura as defined is characterized by various clinical features, including abdominal pain, arthralgia, epididymitis and nephritis which could occur before the appearance of purpura. Therefore, we suggest that the possibility of HSP should be considered in children before invasive procedures, even if the above symptoms and signs present without purpura.
Key Words: Henoch-Sch nlein purpura, Systemic vasculitis, Nephritis, Prognosis


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