Clinical Study Of The Genital Involvement Of Children With Henoch Schonlein Purpura

OBJECTIVE The Henoch-Sch?nlein purpura is a self limiting systemic vasculitis,its pathogenesis is mainly caused by Ig A mediated immune complex deposition in the skin,gastrointestinal tract,genitalia,kidneys and other organs,the clinical features were non thrombocytopenic purpura,occurs in 2-8 years old children.The clinical HSP patients with genital involvement is rare,but because of the lack of specific clinical manifestations,if skin purpura appears later than genital involvement,easily misdiagnosed as acute testicular torsion,increased surgical intervention rate,so as to improve the clinical diagnosis and treatment of HSP patients with genital involvement,508 cases of HSP in January 2010 to December 2016 in our hospital were retrospectively analyzed,compared and analyzed the clinical data of genital involvement in children with non genital involvement,risk factor screening of children with HSP genital involvement,in order to provide theoretical basis for clinical diagnosis and treatment in the future.METHODS From January 2010 to December 2016,508 children with HSP in our hospital from January 2010 to December 2016 were collected,and all the clinical data were collected.According to whether there were genital involvement,they were divided into two groups: 28 cases of genital involvement group and 480 cases of non genital involvement group.The age,inducement,season,clinical manifestation,B ultrasonic examination,platelet count(Platelet,PLT)count and D-two mer(D-Dimer,D-D)level in two groups were compared.After discharge,children with genital involvement were followed up.RESULTS 1.The clinical data of the two groups were compared with those of the non genu group: the age was smaller(6.0±1.98 vs 8.16 ± 2.92,p<0.05),the average hospitalization days were longer(9.86 + 5.68 vs 7.94±4.48,P<0.05),and the D-two polymer level was higher(5.47±2.45 vs 2.79±1.5,P<0.05).2.More than 3 parts of skin purpura and joint and muscle involvement,gastrointestinal bleeding,renal involvement and scalp and soft tissue swelling in the genital involvement group is higher than that in non genital involvement group,the difference was statistically significant;3.Significant differences of parameters between the two groups were analyzed with multivariate Logistic regression analysis showed that age,gastrointestinal bleeding,scalp and soft tissue swelling and elevated levels of a D-D and HSP with genital involvement is closely related(P<0.05).4.28 cases of HSP complicated with genital involvement were followed up for more than half a year.All the symptoms of genital involvement were relieved quickly after treatment with corticosteroids,and no recurrence was found.CONCLUSION 1.The onset age of HSP children with genital involvement was smaller than that of normal HSP,and the number of days in hospital was longer.2.HSP children with genital involvement showed more than 3 sites of skin purpura,joint and muscle involvement,gastrointestinal bleeding,renal involvement,and scalp and soft tissue swelling rates were higher than those in HSP group.3.Multivariate Logistic regression analysis showed that: younger age,gastrointestinal bleeding,scalp and soft tissue swelling and elevated D-D level could be considered as a risk factor for HSP genitalia involvement.We should closely observe the change of children's condition.4.Adrenocorticotropin has good therapeutic effect on HSP combined with genitals.