Henoch-Schonlein Purpura In Children:Clinicolaboratory Characteristics And Prognosis

Objective: Henoch-Schonlein purpura is an allergic disease which mainly caused by small blood vessels.It is one of the most common vasculitis in children and is based on inflammation of small blood vessels.Its clinical manifestations are mainly nonthrombocytopenic purpura,accompanied or not accompanied by different levels of joint swelling and pain,joint movement imitation,abdominal pain,gastrointestinal bleeding and kidney inflammation.The purpose of this study is to analyze retrospectively anaphylactoid purpura(HSP)clinical characteristics and laboratory data collected from326 children which were treated by the hospital in the past 7 years,to explore the characteristics of clinical incidence of children with anaphylactoid purpura in the region and to provide some clinical evidence for hematology indexes in different children in terms of occurrence,diagnosis,development,treatment and other aspects.Methods: The medical records of HSP patients(less than 15 years old)admitted to the hospital from January 2012 to November 2019 were retrospectively analyzed.The clinical and pathological data of the patients were collected throughthe electronic medical record management system and recorded in EXCEL database.The statistical software SPSS 19 was used for retrospective analysis.1.Children were divided into male group and female group according to their gender;Children were divided into renal injury group and non-renal injury group according to whether the children have renal injury or not;2.The onset time of children was recorded statistically to analyze whether disease onset age is related to anaphylactoid purpura,while child’s age is further divided into young children(less than 3 years old),preschool(3 to 6 years old),school age(6 to 10 years old)and adolescent(more than 10 years old)for statistics analysis to analyze different age groups which have the tendency to develop this disease,and whether men and women sex,kidney damage are related to onset age;3.Accordingto the statistics of the onset time in a year,childern were further divided into spring group(March to May),summer group(June to August),autumn group(September to November)and winter group(December to Feburary of the next year)to discuss the peak onset time and to analyze whether gender,kidney damage and are related to onset time;4.The first symptoms of the patients were recorded,and the most common manifestations were analyzed.Then whether the different first symptoms were related to gender and kidney damage would be recorded too;5.Analyze the laboratory hematological indicators of HSP patients,including blood routine,inflammatory indicators,immuno globulin,complement,mycoplasma,etc.to see whether these indicators are helpful for the judgment of renal injury.Results: 1.The incidence rate of boys was higher than that of girls,and the gender difference had an impact on the renal injury of anaphylactoid purpura.The peak of HSP is between 6 and 7 years old,and autumn is the peak season of HSP.2.Most cases of HSP had no obvious cause,and infection is probably the most common cause,among which respiratory tract infection is the most common.3.The typical manifestations of HSP were rash,abdominal symptoms,joint symptoms,etc.And the most common first symptoms were skin lesions.4.There was a statistical difference in HSP gender with or without renal injury(P<0.05).There was no statistical difference in age,month and first symptom of onset between males and females(P> 0.05).5.There was no statistical difference in age,month,and first symptoms of onset of HSP between the renal injury group and the non-renal injury group(P> 0.05).6.There was statistical difference between the occurrence of renal injury of HSP and IgA,IgM,NLR,LMR indicators(P<0.05).Conclusion: In the pathogenesis of HSP,6-7 years old is the peak period of morbidity,and the early school age and school age are both common morbidity periods.Males are more common than females,and the gender difference may be related to renal injury caused by anaphylactoid purpura.The onset time of HSP can be in all four seasons of the year,mainly in the autumn(September to November).There is no obvious correlation between the onset season and gender difference or the occurrence of kidneyinjury.The etiology of HSP is still unclear.This study shows that most of HSP had no obvious cause before onset,followed by infection.However,there is no significant correlation between the cause of HSP and gender or the occurrence of kidney injury.The clinical symptoms of HSP appeared in different sequences.In this study,the number of patients with skin symptoms as the primary reason for seeking medical treatment is the largest,and there is no significant correlation between the first symptoms and the occurrence of renal injury.This study suggests that IgA,IgM,NLR and LMR are related to renal injury of HSP.Therefore,blood routine and immunoglobulin examination were very important in the diagnosis and treatment of anaphylactoid purpura,which help us to determine whether there is a possibility of progression to renal injury.However,there is no clear correlation between complement C3,C4,inflammatory indicators and the occurrence of mycoplasma pneumoniae infection and HSP renal injury.