Clinical Retrospective Analysis Of Henoch-sch(?)nlein Purpura In Adults

Objective: To study the clinical characteristics of adult anaphylactoid purpura in terms of general data,clinical characteristics and laboratory examination,and analyze the relevant risk factors of adult HSP complicated with kidney,joint and digestive tract involvement,so as to provide evidence basis for clinical diagnosis and treatment.Methods: Collected the clinical data of 155 adult in-patients with HSP diagnosed in the dermatology department of our hospital from January 2015 to October 2022.Grouping:1.According to the clinical classification criteria,it is divided into simple type,kidney type,joint type,abdominal type and mixed type;2.According to the system involvement,it is divided into system involvement group and system non-involved group.The system includes kidney,joint and digestive tract.Results: 1.A total of 155 adult HSP patients were included,including 71 males and 84 females,with a ratio of 0.84:1.44 cases(28.4%)were aged 60 or older,and 39 cases(25.2%)were aged 18 to 29.2.Among the patients with predisposing factors,34(60.7%)had upper respiratory tract infection.3.The proportions of various clinical types were as follows: mixed type 49 cases(31.6%),simple type 44 cases(28.4%),renal type 24 cases(15.5%),joint type 20 cases(12.9%),abdominal type 18 cases(11.6%).In adult mixed type HSP,the proportion of each situation is as follows: joint&digestive tract involvement in 36 cases(61.0%),kidney&digestive tract involvement in 8 cases(13.6%),kidney&joint&digestive tract involvement in 8 cases(13.6%),kidney&joint involvement in 7 cases(11.9%).All patients had skin purpura(155 cases,100.0%).The incidence of other system involvement was 33.5%(52 cases)of digestive tract involvement,32.9%(51 cases)of joint involvement,and 14.8%(23 cases)of kidney involvement.4.The univariate analysis of the involvement of each system showed that there were statistically significant differences in diabetes,hypertension,relapse,Ig M,age,and the number of days of rash duration between the groups with and without kidney involvement(P<0.05).Compared with the group without kidney involvement,the median level of age and the number of days of rash duration was higher,and the median level of Ig M was lower.Age group,hypertension,persistent purpura,PLT,C3,PLR,WBC,NE,EO,MCV,NLR,CRP and age were significantly different between the groups with and without joint involvement(P<0.05).Compared with the group without joint involvement,the median level of WBC,NE,NLR and CRP was higher,the median level of EO,MCV and age was lower,and the average level of PLT,C3 and PLR was lower.Age group,hypertension,PLT,Fbg,WBC,NE,MO,EO,NLR,Ig G,age were significantly different between the groups with and without digestive tract involvement(P<0.05).Compared with the group without digestive tract involvement,the median level of WBC,NE,MO,NLR was higher,the median level of EO,Ig G was lower,and the mean level of PLT and Fbg was lower.Binary logistic regression analysis showed that there was an independent association between relapse,Ig M and renal involvement in adult HSP patients(P<0.05),persistent purpura and joint involvement in adult HSP patients(P<0.05),and PLT,Ig G and gastrointestinal involvement in adult HSP patients(P<0.05).Conclusions: 1.In adult HSP patients,the incidence rate of men and women is equal,the ratio is 0.84:1;The distribution proportion of all age groups is the same,with the largest proportion of people aged 60 or older,followed by people aged 18 to 29;Upper respiratory tract infection was the main inducement;The proportion of mixed type is the most,the abdominal type is the least,and the digestive tract is the most common;In the mixed type,joint involvement&digestive tract involvement is the most common.2.Diabetes,hypertension,relapse,Ig M,age,and the duration of rash are related risk factors for adult HSP patients with renal involvement;The increase of age,the level of rash duration days and the decrease of Ig M level were correlated with renal involvement in adult HSP patients;Recurrence and Ig M are independent risk factors for renal involvement in adult HSP patients.3.Age,hypertension,persistent purpura,PLT,C3,PLR,WBC,NE,EO,MCV,NLR,CRP,age are the risk factors of joint involvement in adult HSP patients;The increase of WBC,NE,NLR and CRP levels and the decrease of PLT,C3,PLR,EO,MCV and age levels were correlated with the joint involvement in adult HSP patients;Persistent purpura is an independent risk factor of joint involvement in adult HSP patients.4.Age,hypertension,PLT,Fbg,WBC,NE,MO,EO,NLR,Ig G and age are the relevant risk factors of adult HSP patients with digestive tract involvement damage;The increase of WBC,NE,MO,NLR levels and the decrease of EO,Ig G,PLT,Fbg levels were correlated with renal involvement in adult HSP patients;PLT and Ig G are independent risk factors of digestive tract involvement in adult HSP patients.