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Kang Y, Park JS, Ha YJ, Kang MI, Park HJ, Lee SW, Lee SK, Park YB. Differences in clinical manifestations and outcomes between adult and child patients with Henoch-Schönlein purpura. J Korean Med Sci 2014; 29:198-203. [PMID: 24550645 PMCID: PMC3923997 DOI: 10.3346/jkms.2014.29.2.198] [Citation(s) in RCA: 87] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2013] [Accepted: 11/19/2013] [Indexed: 11/20/2022] Open
Abstract
We aimed to investigate differences in clinical manifestations and outcomes between adult and child patients with Henoch-Schönlein purpura (HSP), and to analyze the factors associated with poor prognosis for HSP nephritis. This retrospective 10-yr study enrolled 160 patients with HSP who visited Severance Hospital. Purpura was mostly detected in lower extremities, but purpura in upper extremities was more frequently observed in adults than children (41.7% vs 19.3%). Children had a greater frequency of arthralgia (55.4% vs 27.1%), while adults had a greater frequency of diarrhea (20% vs 1.6%). Anemia, elevated C-reactive protein, and level of IgA were more frequently observed in adults (25% vs 7.1%, 65.6% vs 38.4%, 26.3% vs 3.5%). Renal involvement in adults was more severe than in children (79.2% vs 30.4%). Chronic renal failure showed a significant difference in outcomes of HSP between adults (10.4%) and children (1.8%) after a follow up period of an average of 27 months. Furthermore, renal insufficiency at diagnosis was significantly related to the progression to chronic renal failure. Our results showed several differences in the clinical features of HSP between adults and children. Adults with HSP had a higher frequency of renal insufficiency and worse renal outcomes than children. Renal insufficiency at diagnosis might be of predictive value for the progression to chronic renal failure in HSP patients.
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Affiliation(s)
- Yoon Kang
- Division of Rheumatology, Department of Internal Medicine, Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Jin-su Park
- Division of Rheumatology, Department of Internal Medicine, Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - You-Jung Ha
- Division of Rheumatology, Department of Internal Medicine, Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Mi-il Kang
- Division of Rheumatology, Department of Internal Medicine, Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Hee-Jin Park
- Division of Rheumatology, Department of Internal Medicine, Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Sang-Won Lee
- Division of Rheumatology, Department of Internal Medicine, Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Soo-Kon Lee
- Division of Rheumatology, Department of Internal Medicine, Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea
| | - Yong-Beom Park
- Division of Rheumatology, Department of Internal Medicine, Institute for Immunology and Immunological Diseases, Yonsei University College of Medicine, Seoul, Korea
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Tabata R, Tabata C, Namiuchi S, Terada M, Yasumizu R, Okamoto T, Nagai T. Adult T-cell lymphoma mimicking Henoch–Schönlein purpura. Mod Rheumatol 2014. [DOI: 10.3109/s10165-006-0534-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Tabata R, Tabata C, Namiuchi S, Terada M, Yasumizu R, Okamoto T, Nagai T. Adult T-cell lymphoma mimicking Henoch-Schönlein purpura. Mod Rheumatol 2007; 17:57-62. [PMID: 17278024 DOI: 10.1007/s10165-006-0534-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2006] [Accepted: 09/27/2006] [Indexed: 10/23/2022]
Abstract
We report a male patient with adult T-cell lymphoma, who was initially diagnosed clinically as having Henoch-Schönlein purpura (HSP) with abdominal pain and specific purpura. Adult T-cell lymphoma-like cells were minimal and abdominal lymph nodes were transiently swollen, and the symptoms were improved by supportive management. Although the clinical course was compatible with HSP, the histological examination revealed infiltration of lymphocytes rather than neutrophils. Later he developed lymphoma and was treated with chemotherapy. This rare case suggests the importance of skin biopsies to seek the underlying pathology in adult HSP.
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Affiliation(s)
- Rie Tabata
- Department of Internal Medicine, Hyogo Prefectural Tsukaguchi Hospital, 6-8-17 Minamitsukaguchi, Amagasaki, Hyogo 661-0012, Japan.
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