All issues > Volume 36(8); 1993

Original Article

J Korean Pediatr Soc. 1993;36(8):1124-1132. Published online August 15, 1993.

Clinical Studies of Henoch-Schölein Purpura Which was Considered as Acute Abdomen

Seong Young SY Jeong¹, Seong Yun SY Cho¹, Chio Heong CH Park¹, Seong Ho SH Cha¹, Byoung Soo BS Cho¹, Chang Il CI Ahn¹

¹Department of Pediatrics, College of Medicine, Kyung Hee University, Seoul, Korea

Abstract

Henoch-Schölein purpura is a common pediatric disease presenting most frequently with skin, gastrointestinal, joint and renal manifestations. But in cases are infrequently only severe gastointestinal manifestations. It is hard to diagnose promptly and exactly. Clinical manifestations and laboratory findings were observed and analyzed in 20 cases with Henoch-Schölein purpura which were considered as acute abdomen, hospitalized at Kyung Hee university Hospital during the period from December, 1982 to September, 1992. The following results were obtained; 1) The age distribution of Henoch-Schölein purpura had a peak incidence between 7 to 9 year old. And male preponderance was observed with male to female ratio of 2.33 to 1. 2) The most prevalent season for the initial presentation of Henoch-Schölein purpura was in 10 cases(50%). 3) The frequency of each type of clinical manifestations showed 20 (100%), 20 (100%), 18(90%), 8(40%) cases for skin, gastrointestinal, joint and renal manifestation respectively in order of frequency. 4) The common previous illness were URI, 40 cases(50%) and allergy, 2 cases (10%.) 5) The onset time of skin manifestation from admission were 1 to 4 days (75% 0,5 to 8 days (15%), 9 to 12 days (10%) explolaparotomies were done the last 2 cases. 6) In all cases, X-ray study (100%), abdominal sono (50%), Meckels scan and colon study (5%) respectively were done. 7) Hematologically leukocytosis over 10,000/mm3 was observed in 80% of cases and increase in ESR over 20mm/hr in 65% of cases. Coagulation studies, immunologic and complement level revealed the result within normal range in most of the cases. 8) Among 8 cases with renal involvement, all cases had both hematuria and proteinuria. 9) Most cases were recovered within 4 weeks but in 4 cases, renal biopsies were done because of relapse. The results were Meadow classification grade I(1 cases), II (1 cases), IV a (2 cases). After renal biopsy, steroid pulse therapy was started.

Keywords :Henoch-Schölein purpura, Acte abdomen