جستجوی مقالات مرتبط با کلیدواژه "henoch-schonlein purpura" در نشریات گروه "پزشکی"

 Henoch-Schönlein purpura (HSP) is the most common type of vasculitis in children. Children with HSP often experience gastrointestinal symptoms, such as abdominal pain, nausea/vomiting, gastrointestinal bleeding, and intussusception. These symptoms are estimated to occur in 50 - 75% of cases.

 In this study, we evaluated the prevalence of gastrointestinal manifestations in children with HSP and identified associated predictive factors.

 For this cross-sectional study, we collected data from 295 children with HSP, aged 1 to 16, who were treated at Mofid Children's Hospital in Tehran, Iran, between 2013 and 2022. We gathered the following information from hospital records: Laboratory results for ALT, AST, bilirubin, stool exam (S/E), WBC, RBC, and occult blood (OB), as well as demographic data. Clinical symptoms evaluated included fever, rash, abdominal pain, distension, tenderness, nausea/vomiting, diarrhea, anorexia, and icterus.

 Our study included 295 children diagnosed with HSP, consisting of 46.77% females and 53.23% males. The average age was 5.3 ± 2.8 years for female patients and 6.2 ± 2.9 years for male patients. Further analysis indicated that anorexia was the most common symptom, followed by abdominal pain, diarrhea, nausea/vomiting, and bloody stool. We observed no significant differences in symptoms based on sex. Physical examination findings, including abdominal distension and tenderness, were similar across both sexes. Elevated levels of AST and ALT, as well as hyperbilirubinemia, were noted in some patients. Stool analysis revealed positive results for RBC, WBC, and occult blood in certain cases, with 21% testing positive for RBC, 24.85% for WBC, and 23.25% for occult blood. Anorexia showed a correlation with increased AST levels, while bloody stool was associated with higher ALT levels, hyperbilirubinemia, and direct hyperbilirubinemia. Logistic regression analysis confirmed a significant association between bloody stools and elevated ALT levels.

 In this study, we examined the clinical manifestations and laboratory findings in children with small vessel vasculitis to identify associated predictive factors. Our findings indicated that anorexia and abdominal pain were the most common clinical manifestations, with bloody stool also being a prevalent symptom. Additionally, logistic regression analysis demonstrated that the presence of bloody stool is a significant predictive factor for elevated ALT levels.

Renal involvement is the most damaging long-term complication of Immunoglobulin-A (IgA) vasculitis. In the lack of a definite predictive biomarker for renal involvement, antiphospholipid antibodies (aPL) have been proposed in recent years.

In this prospective cohort of 48 pediatric patients who were admitted with IgA vasculitis from September 2015 to June 2017, two serum samples were taken 12 weeks apart to detect Anti-Phospholipid antibodies. All patients were followed-up for renal involvement for six months.

Renal involvement occurred in 14 out of 48 patients with IgA vasculitis (29.16%). APLs were positive in nine out of 14 patients with IgA vasculitis and renal involvement (64.28%), in contrast to only six out of 34 patients with IgA vasculitis without renal involvement (17.64%). The presence of aPL antibodies was statistically associated with renal involvement (P=0.002).  Although, the relationship between both sex (P=0.025) and age (P=0.046) with aPL positivity was statistically significant, performing a modified logistic regression test, the odds ratio was significant between the groups with and without renal involvement only in term of age and aPL positivity).

The presence of aPL antibodies was statistically associated with renal involvement. We found a significant relationship between the age and aPL positivity. Hence, we need multicenter, more extensive cohort studies to reach a better and more accurate conclusion on the relationship between serum aPLs and renal involvement in IgA vasculitis patients.

High-mobility group box-1 (HMGB1), a nuclear protein, plays an important role in the pathogenesis of HenochSchönlein purpura (HSP). In a Chinese child population, the correlation between susceptibility to HSP and genetic variation in the HMGB1 gene and also the relationship between HMGB1 gene polymorphism and clinical heterogeneity of HSP were investigated.

We analyzed two HMGB1 tag single nucleotide polymorphisms (SNPs; rs3742305 and rs9508752) in 182 HSP patients and 202 healthy controls using the matrix-assisted laser desorption/ionization time-of-flight mass spectrometry method.

There were no significant differences between HSP patients and controls in the frequency of alleles, genotypes, and haplotypes of HMGB1 SNPs. In addition, there was a slight association betweenHMGB1 gene polymorphisms and the clinicalmanifestations of HSP.

It is suggested that the variation of the HMGB1 gene was not highly correlated with the susceptibility of Chinese children to HSP.

Purpuric nephritis is the most common secondary glomerular disease in childhood. Its prevalence in children has been steadily rising in recent years.

To explore the characteristics and pathogenesis of peripheral blood lymphocyte subsets and immune function changes in children with Henoch-Schonlein purpura nephritis.

The study included 104 children with Henoch-Schonlein purpura, divided into nephritis (HSPN) group (68 cases) and non-nephritis (NHSPN) group (36 cases), and 15 normal children were included as the control group. The rate-scatter turbidimetric method was utilized to determine the immunoglobulins IgA, IgG, IgM, C3 and C4, and the flow cytometry analysis technique was employed to detect the levels of lymphocyte subsets such as CD3+, CD4+, CD8+, CD4+/CD8+, CD19+, NK, etc.

Compared with the control group, the CD3+, CD4+, CD8+ and NK cell levels of peripheral blood mononuclear cells in the HSPN group and the NHSPN group significantly decreased (P<0.05), and the CD19+ level significantly elevated (P<0.05); whereas the HSPN group had a more significant change than the NHSPN group (P<0.05). Compared with the control group, the serum immunoglobulin IgA and IgG of the HSPN group and the NHSPN group significantly increased, and the IgM, C3, and C4 significantly decreased (P<0.05); while the HSPN group had a more significant change than the NHSPN group (P<0.05).

Immune dysfunction in children with HSPN is specifically manifested as low cellular immune function, which leads to an increased secretion of inflammatory mediators, activates B cells, and further increases the secretion of immunoglobulins, leading to the occurrence of small vasculitis.

Henoch-Schönlein purpura (HSP) is the most common childhood vasculitis characterized by leukocytoclastic vasculitis. This study was done to describe the presentation and immediate outcome of children admitted to HSP at our Institute.

This retrospective study was conducted on children with HSP admitted to our department over a period of 7 years (January 2010 until December 2016).

Twenty-three children with a diagnosis of HSP were identified during the study period. The mean age was 9.4 years (4 years to 16 years). There were 15 girls and 8 boys with a male: female ratio of 1:1.9. The youngest child was 4 years old and most of the children (73.9%) were in the age group 5-12 years. Forty percent of the children presented between January and March. Major manifestations were rash (100%), joint pain (52%), renal involvement (52%), and abdominal pain (47.8%). Three (13.0%) children presented with systemic manifestations before the appearance of the rash. One child had MPGN 2 years before the onset of rash. There was no mortality. Most of the children recovered well; six (26%) had persistent hypertension and three (13%) had persistent proteinuria. Hypertensive emergency was seen in two children. One child had intussusception that resolved spontaneously.

This study is the first study of Henoch Schonlein purpura from northeast India documenting certain peculiarities in the presentation. The results indicate a wide spectrum of presentations in HSP

Context: 

Henoch-Schonlein purpura (HSP) is a significant cause of chronic renal disease in children. This review determines some risk factors associated with renal involvement in childhood HSP. 

Evidence Acquisition:

 Electronic databases, including Google Scholar, PubMed, and Scopus were searched using the following keywords: “children”, “Henoch-Schonlein”, “risk factor”, “renal involvement”, and “IgA vasculitis”. This review was designed to identify the relevant electronic studies published in the English language from December 1998 to August 2018.

This review revealed that clinically older age at presentation, persistent rash, atypical rash, rash on unusual location, and gastrointestinal bleeding were significant risk factors for renal involvement. In contrast, joint involvement was not associated with renal involvement. Among biochemical markers, high red blood cell distribution width is a risk marker of renal involvement in HSP. In contrast, peripheral blood immunoglobulin A, antinuclear antibody, anti-streptolysin O titer, erythrocyte sedimentation rate, and C-reactive protein were not associated with renal involvement. In several studies, leukocytosis, thrombocytosis, or thrombocytopenia have been mentioned as predictors for renal involvement. Still, other studies showed the white blood cell count or platelet count are not risk factors. The effect of corticosteroids as a predictive factor of renal involvement in HSP is challenging and controversial. Furthermore, their impact was dose-dependent.

Demographic factors, clinical features, and some abnormal laboratory findings are significant predictive factors for renal involvement in HSP.

 Henoch-Schönlein purpura (HSP) is one of the most common systemic types of vasculitis in children. Although it is a self-limited disease, life-threatening complications such as nephritis may occur. Early diagnosis and follow up might improve the long term outcome in renal involvement. There are few studies that have evaluated HSP in Iran.

 The purpose of this study was to investigate demographic, laboratory data and clinical presentations of admitted HSP patients in a tertiary referral center, over a twelve-year period.

 This retrospective descriptive study evaluated 195 patients, diagnosed with HSP, who were admitted to Namazi Hospital in southwest of Iran (2006 - 2018). Demographic, clinical and laboratory findings, as well as treatment outcome of HSP patients were collected.

 There were 118 males and 77 females with the mean age of 6.7 ± 3.21 years. About 70 (36%) patients showed common cold symptoms two weeks before HSP presentations. Admission course was 1 - 17 days (mean 4.55 ± 2.83) and autumn was recorded with the highest number of admitted patients (44.1%). In the course of hospitalization, 100% of the patients presented with palpable purpura, 61.02% with joint pain and 19.49% with abdominal pain. Moreover, 17.95% of the patients were noted with renal involvement. Laboratory data shows that more than half of patients (54%) had leukocytosis, only 9% of patients had positive CRP but all the patients had high erythrocyte sedimentation rate (ESR). Total of 43.1% of the patients received corticosteroids.

 The observed number of male patients with HSP was higher than females and the highest frequency of the HSP cases was observed in autumn. Joint pain and abdominal pain were the predominant clinical presentations, following skin purpura. The presented data can help with further HSP diagnosis and treatment plan.

Systemic lupus erythematosus is an autoimmune disease associated with systemic involvement. Various organs including skin, kidneys, joints, heart, and central nervous system, may be affected. One of the serious organ damages in SLE is renal involvement as lupus nephritis, which occurs in 50-75% of children with SLE. Approximately 6-12% of pediatric SLE may develop other conditions, such as JIA, JDM, and polymyositis, scleroderma, and Crohn's disease. Henoch schönlein purpura (HSP) is another disease that accompanies with SLE. There have been several reports of HSP as the primary manifestation of SLE. In this report, we aim to highlight lupus nephritis as the first presentation of SLE and its association with HSP in our patient, a 6-year-old boy with lupus nephritis and past history of HSP 4 years before initiating of SLE.

Henoch-Schönlein purpura (HSP) is the most widespread systemic small-vessel vasculitis of childhood. Limited information exists about the epidemiology, allergen and laboratory bio-markers reflecting HSP disease phases in Northwestern China.

To comprehensively evaluate the epidemiology, allergen and laboratory bio-markers reflecting HSP disease phases for the first time in this region.

We retrospectively evaluated 135 HSP patients and 86 controls aged ≤ 14 years admitted to the Children's Hospital of Gansu Province between January 2016 and December 2017. Epidemiological profiles, clinical characteristics and laboratory biomarkers of both inflammation and activated coagulation were analyzed for each HSP patients and controls. The monocyte-to-lymphocyte ratio (MLR), neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) were calculated based upon the results of routine blood tests performed during hospital stay of the patients.

In total, 77 patients had arthritis, 46 had gastrointestinal involvement and 15 had renal involvement. The most common predisposing factors were upper and lower respiratory tract infections, allergies and seasonal variation. Frequency of renal involvement was significantly higher among patients older than 7 years but lower with a positive rate of allergens. The average levels of C-reactive protein, white blood cells (WBC), neutrophils, platelets, D-dimer, fibrin degradation product (FDP), NLR and PLR among patients were significantly increased compared with the control group. Sensitivity and specificity were highest for neutrophil counts, while the area under the curve (AUC) for platelet count was highest. Patients with gastrointestinal involvement had significantly higher WBC, neutrophil count, D-dimer and FDP levels than those without. Sensitivity, specificity and AUC were highest for neutrophil counts. Increased D-dimer levels were significantly associated with gastrointestinal involvement and renal involvement.

The first report of epidemiologic characteristics of HSP in children in this area enriches the HSP epidemiological data of China. Exposure to allergens should be reduced in patients aged approximately 7 years and renal involvement should be carefully monitored in patients aged > 7 years. WBC count, neutrophil, D-dimer and FDP levels are better than conventional infection markers. Particularly, D-dimer is an independent predictor on HSP patients with gastrointestinal involvement and renal involvement.

Despite the spread of Henoch-Schonlein purpura (HSP) in all societies, especially in Asian children, no comprehensive study on HSP has been conducted in Iranian children and most of these reports are limited to disease cases or exclusively to patients with HSP. Therefore, this study was conducted to describe the clinical, diagnostic, and therapeutic approaches in children with HSP in Iran.

This historical cohort study was performed in all children suffering from HSPN hospitalized at Ali-Asghar Children’s Hospital, Tehran between April 2006 and March 2017. The patients' baseline characteristics including demographics, clinical symptoms and laboratory parameters were all collected from hospital files. The patients were followed up for at least six months of initiating treatment and also for 12 to 120 months after treatment.  

Of 100 patients with HSP, 18 (11 boys and 7 girls) had indications for biopsy that were included in the study. The mean age of the participants was 7.72 ± 2.69 years. Nephrotic syndrome was found in 44.4% and nephritic syndrome in 61.1% of the patients. Hematuria was found in 66.7%, proteinuria in 66.7%, and hypertension in 38.9% of the patients. The mean serum creatinine was 1.0 ± 0.6 mg/dl with a mean GFR of 95 ± 5ml/min. Regarding pathological classification, 33.3% had class II and 66.7% had class III. With respect to therapeutic regimen, 61.1% were treated only with steroids while others were treated with a combination of steroids and immunosuppressant drugs. During the follow-up time, all patients were treated successfully with the mentioned regimens. In all treated subjects, proteinuria disappeared in all urine samples. Due to complete improvement in all patients, repeated renal biopsy was not indicated.

Kidney involvement occurs as nephritic syndrome in about two thirds of patients and as nephrotic syndrome in the remaining cases. In the majority of patients, treatment with steroids alone is successful although combined therapy with immunosuppressant drugs is required in the remaining patients. In summary, the therapeutic protocols are associated with a significant long-term recovery (a five-year recovery of 87.5% in our study).Keywords: Henoch-Schonlein purpura; Nephritis; Nephrotic syndrome; Child.

Henoch-Schönlein purpura (HSP) is an immune-complex mediated vasculitis affecting small vessels with dominant IgA deposits. It is seen mostly in children, with a self-limiting disease, but can present with more severe clinical features in older patients, such as gastrointestinal (GI) involvement, with a propensity for rapid progression. In this report, we describe our experience with a male HSP patient who presented with pneumonia, palpable purpuric rash, severe GI involvement with hemodynamic compromise and acute kidney injury. Even though we escalated therapy over time given the lack of response with each previous strategy, with corticosteroids and cyclophosphamide, he developed massive lower gastrointestinal hemorrhage that was not responsive to any supportive measure and died as a result of hemorrhagic shock. There was no established protocol that guided this treatment due to lack of rigorous data, which emphasizes the need for more studies on adult HSP in order to establish the optimal management for HSP patients with severe gastrointestinal manifestations.

People of all ages can su?er from Henoch?Schönlein purpura (HSP), but it is the most common vasculitis in childhood. Te most important involving gene is located on chromosome 6p21.3, a region coding for human leukocyte antigens (HLAs). Among HLA genes, because of the high rate of polymorphisms, HLA?DRB1 is estimated to have a strong association with HSP. In this study, we aimed to assess the association of HLA?DRB1 alleles with HSP in Iranian children.
Tis study consisted of thirty Iranian children with HSP and 35 healthy controls. Genomic DNA was extracted, and HLA typing was performed by polymerase chain reaction with sequence?specifc primers technique.
Te results have shown that HLA?DRB1*01 and HLA?DRB1*11 (P = 0.002, odds ratio [OR] = 7.579, confdence interval [CI] = 1.934–29.697 and P = 0.039, OR = 3.333, CI = 1.030–10.788), respectively, are the most frequent alleles associated with HSP in Iranian children population. Te frequency of other alleles was not signifcantly di?erent in both groups. Te results also show no correlation between HLA types and disease manifestations.
According to these results, there is an association between HLA?DRB1*01 and HLA?DRB1*11 gene polymorphisms and susceptibility to HSP in our study group.

Henoch Schonlein Purpura (HSP) is one of the most common vasculitic diseases of childhood. Considering the effects of resistin in inflammation, we hypothesized that resistin was important in the pathogenesis of HSP. Therefore, the aim of this study was to investigate the serum and urinary resistin levels of patients with HSP and compare them with those of healthy subjects.
The study was performed between March 2015 and September 2015 at University of Health Sciences, Umraniye Training and Research Hospital, Department of Pediatrics. Fifteen children with HSP were evaluated during the acute phase and compared with fifteen healthy age- and sex-matched controls.
A total of 30 children, 15 of whom were in the HSP group participated in the study. There were fifteen children with a median age of 8.65 ± 4.35 years in the HSP group, of whom 9 (60%) were male and 6 (40%) were female. In the control group, there were 15 children with 6 (60%) males and 4 (40%) females, aged 3 to 16 years. The serum resistin level of the HSP group (53.96 ± 33.61 ng/ml) was significantly higher than that of the control group (19.46 ± 4.42 ng/ml) (P The effects of resistin in vasculitic disorders have not been clearly demonstrated so far. In our study serum and urinary resistin levels were significantly higher in patients with acute stage of HSP than that in the healthy control group. According to our results, serum and urinary resistin levels could be used as a diagnostic or prognostic marker and be considered as a secondary epiphenomenon in children with HSP.Further studies are warranted to elucidate the pathogenic mechanisms by which serum and urinary resistin levels elevate in HSP patients with kidney involvement and relapses.

To summarize the experience of diagnosing and treating patients with Henoch– Schönlein purpura (HSP)?related pancreatitis, a systematic review of previously published cases was conducted. Among 13 reported cases, there were six males and seven females whose age from 3 to 70 years. The clinical features of these patients indicated that acute pancreatitis could be the initial manifestation of HSP, the radiological change was atypical, and most cases were alleviated with steroidal treatment. Good outcomes can be achieved in patients who are diagnosed early with HSP?related pancreatitis, and it is vital to begin timely treatment of HSP?related pancreatitis with corticosteroid.

Gastrointestinal (GI) manifestations are common in patients with Henoch Schonlein Purpura (HSP) and it seems that ultrasound is the first modality for detecting GI involvement. This study was performed to evaluate the relationship between sonographic findings and clinical, and paraclinical symptoms.
All patients with HSP referred to our clinic in 2011 and 2012, were enrolled in the study. The data including sonographic and other lab tests were collected and analyzed, and the association between sonographic findings and clinical, and paraclinical symptoms were evaluated.
Among 112 patients (68 males and 44 females), 28 cases had abnormality in their sonography that was higher in patients with GI and renal symptoms. Furthermore, length of hospitalization and need for corticosteroids was greater in patients with positive sonographic findings.
In patients with HSP, ultrasound is a valuable modality to determine the prognosis of the disease.