All issues > Volume 28(6); 1985

Original Article

J Korean Pediatr Soc. 1985;28(6):545-554. Published online June 30, 1985.

Clinical Studies of Anaphylactoid Purpura in Childhood.

Kwang Hyun Kim, Kwang Nam Kim, Ha Baik Lee, Hang Lee

¹Dept, of Pediatrics, Hanyang University, College of Medicine

Abstract

Anaphylactoid purpura or Henoch-Schonlein purpura is a common pediatric disease presenting most frequently with purpura, and occasionally with gastrointestinal and joint manifestations, and has been known to present pathologically with diffuse vasculitis involving small blood vessles in many organs. Clinical manifestations and laboratory findings were observed and analyzed in 110 cases with anaphylactoid purpura hospitalized at Hanyang University Hospital during the period from January, 1975 to June, 1984. Chronicity of the disease was found significant as to the renal aspect of the disease. Renal involvement was observed with laboratory studies to determine clinical and immunological characteristics, and the therapy response was analyzed as to the length of time till the remission was achieved. The summary of the clinical and the laboratory observations is as follows：1)The age distribution of anaphylactoid purpura shows a peak incidence between 5 to 9 years of age. And male preponderance was observed with male to female ratio of 1.3 to 1. 2) The most prevalent season for the initial presentation of anaphylactoid purpura was in spring： in 47 cases(42.7%). 3)The frequency of each type of clinical manifestations showed 110,81,54,34 cases for skin, gastrointestinal, joint and renal manifestations respectively in the order of frequency. 4)As for the skin manifestations, petechia, purpura and ecchymosis were most commonly observed: in 97 cases(88.2%). 5) As for the gastrointestinal symptoms, abdominal pain was most common： in 78 cases (70.9%). 6)As for the joint presentations, knee joint was the most frequently involved site: in 33 cases (30.3%). 7) Hematologically leukocytosis over 10,000/mm3 was observed in 49.1% of cases and increase in ESR over 20 mm/hr in 62» 1% of cases. Clotting studies, including bleeding time, clotting time, P.T., P.T.T. revealed the result within normal range in most of the cases. 8)Among 34 cases with renal involvement, 22 cases had both hematuria and proteinuria, 7 cases had hematuria alone and remaining 5 cases had proteinuria alone 9) Immunoglobulin level was compared between renalinvolved group versus renal non-involved group. Mild elevation of IgA was more frequently observed in renal involved group than non-involved group. 10)The therapy response for conservative only and steroid therapy were compared in 34 renal involved patients, and no significant difference in the length of time before remission was achieved was observed. 11)As to the 34 cases with renal involvement, 9 cases(26.5%) achieved remission within 1 month, and at least 15 cases (44.1%) persisted to show abnormal finding in urinalysis over 1 month after initial presentations.

Keywords :Anaphylactoid purpura