| Clinical Significance of Gastrointestinal Symptoms and Abdominal Ultrasonographic Findings in Henoch-Schönlein Purpura |
|
Eun Jung Choi, Chang Woo Lee, Du Young Choi |
|
Department of Pediatrics, Wonkwang University School of Medicine, Iksan, Korea |
| Henoch-Schönlein 자반증에서 복부 증상의 임상적 의의와 복부 초음파 소견 |
|
최은정, 이창우, 최두영 |
|
원광대학교 의과대학 소아과학교실 |
Correspondence:
Du Young Choi, Email: cdy8118@wonkwang.ac.kr
|
|
|
|
|
| Abstract |
Purpose
: Henoch-Sch nlein purpura(HSP) is a systemic vasculitis, characterized by cutaneous palpable purpura, gastrointestinal(GI) symptoms, arthritis and renal involvement. In general, the prognosis is determined by GI complication as well as the severity of nephritis. In this study, we analyzed the statistical relationship between the GI symptom and other clinical findings for assessing the prognosis, and evaluated abdominal ultrasonographic findings for early diagnosis of this disease with atypical clinical presentation and early detection of serious GI complications.
Methods
: One hundred seventy seven patients with HSP in the Department of Pediatrics, Wonkwang University Hospital from January 1994 to June 2004, were enrolled. We retrospectively analyzed charts about clinical and abdominal ultrasonographic findings, and classified our patients into two groups(GI-Sx(－), GI-Sx(＋)) for statistical analysis.
Results
: The ratio of female to male is 1.5 : 1. The peak age incidence was five to eight years in 95 cases(53%). The GI symptoms appeared in 117 cases(66%), which include abdominal pain 115 (98 %), tenderness 45(38%), nausea and vomiting 35(30%), bloody stool 10(8.5%), diarrhea four(3.4%), rebound tenderness four(3.4%), and also intussusception and appendicitis were complicated in five and two cases respectively. GI-Sx(＋) group had an increased risk of renal involvement and relapse than the GI-Sx(－) group. But there were no relationships about sex and age incidence, or other clinical and laboratory findings between two groups. Ultrasonographic findings in 98 patients with GI symptoms included small bowel thickening in 70 cases(71%) in which duodenum, jejunum and ileum were involved in 71%, 45.7%, 40% respectively, small bowel dilatation in 41 cases(42%), lymph node swelling in 46 cases(47%), and ascites in 25 cases(25.5%).
Conclusion
: GI symptoms in patients with HSP suggested increased risk of renal involvement and relapse. Abdominal ultrasonography could be helpful in the early diagnosis on atypical clinical presentation and early detection of serious GI complication in these patients. |
| Key Words:
Henoch-Schö, nlein purpura, Gastrointestinal symptoms, Ultrasonography |
|
PDF Links
Download Citation
