Pancreatic Involvenent In Children With Henoch-Schonlein Purpura

Objectives Henoch–Sch?nlein purpura(HSP) is the most common systemic, small-vessel vasculitis affecting children,.The skin, joints, gastrointestinal tract, and kidney were the most common system affected.But,pancreatic involvent in HSP is rare.To explore clinical characteristics of pancreatic involvement in children with HSP and in order to improve the early diagnosis, treatment and outcome of it, retrospective analyses the clinical datas of pancreatic involvement in children with HSP were admmition during the last 7 years, and observating systematic the clinical Indicator of it was admmited in our hospital in recesent years.Methods: 1. Retrospective summarized the clinical characteristics, treatment and outcome of pancreatic involvement in HSP with children from January2003 to december 2009. 2. 125 children with HSP, admitted in our hospital from 2010 july to december were enrolled in this study.All children according to whether intestinal tract symptom divided into two groups:the common group HSP53 cases and the HSP72 cases of abdominal group. To collect all children's periheral blood 2ml in the morning with empty stomach, and collecting urine 5ml, send to our biochemistry laboratory together. checkouted the level of blood amylase and urine amylase with Automatic Clinical Chemistry Analyzer,and blood lipase with Dry Chemistry Analyzer by professionals. Check up liver, bravery, spleen, pancreatic, and abdominal cavity with B--ultrasound(BUS) on empty stomach in the same day. The statistics analyese were conducted using SPSS13.0 for windows's software.Results: 1.1253 children with HSP, admitted in our hospital from January2003 to December2009 were enrolled in this study. There were 7children with pancreatic involvement among these children, the incidence is 0.56%(7/1253),and 3 cases was Acute pancreatitis, the incidence is 0.24%( the Practice Parameters Committee of the American College of Gastroenterology,2006).The symptoms of 7 cases of children involved in pancreatic disease occurred in acute phase, both abdominal pain and left upper quadrant tenderness, but neither rigidity nor rebound tenderness; There are level of blood amylase and / or urine amylase significantly increased in laboratory tests and pancreatic imaging is arnomaly(BUS or CT) in all children; There were renal damage varying degrees in all children;7 patients had improvement after intravenous pulse treatment methylprednisolone. The clinical observation in all children from from 2010 july to december was:①6 cases blood amylase's level was rising in 72 cases abdominal HSP group and 5 cases of urine amylase was rising in the same time,2cases was diagnosed as Acute pancreatitis with blood lypase'slevel rising at the same time; There was no case blood lypase rising in the group of 53 common HSP. However,2 cases blood amylase was rise,1 case of urine amylase rising in the same time.the rising was in short time.②The abnormal finding was the Pancreas edge blur and/or internal lightspot echo down, Or main pancreatic duct expansion and so on by BUS examination in 4 cases in the abdominal HSP group; The abnormal finding was pancreas diffuse mild increase, outline and full, gained density and owe evenly in 2 cases with blood amylase and blood amylase rising in the abdominal HSP group,nuder CT examine.There were no abnormal finding in 2 cases which blood amylese was rising under Ultrasound examination of the pancreas in the common group.Conclusions: The incidence of Henoch—Sch?nlein n purpura with pancreatic involvement was0.56%(7/1253)in this datas; The characteristics of Henoch—Sch?nlein purpura with pancreatic involvement e occurred in acute phase; Check up routine in the abdominal HSP Children's hematuria amylase, blood lypase levels and pancreas Imaging Changes was useful of the early diagnosis. Relieve symptoms and prognosis is good by treatment early with intravenous pulse methylprednisolone..