| Objective:To investigate the clinical characteristics of Henoch-Schonlein purpura complicated with different pathogenic infections.Methods : 145 children with HSP hospitalized for the first time in rheumatic Immunology Department of our hospital from January 2014 to January 2018 were collected.General data(age,sex,weight,etc.),clinical characteristics(pathogenesis,course,clinical manifestations),auxiliary examinations(blood routine,urine routine,liver and kidney function,immunoglobulin,24-hour urinary microprotein quantification,ADDIS count,etc.)were collected.According to the presence or absence of infection,they were divided into infection group and non-infection group.According to the different pathogens of infection,they were divided into Mycoplasma pneumoniae infection group,EB virus infection group,cytomegalovirus infection group,Coxsackie B virus infection group,combined with two or more pathogens infection group.Analysis of clinical characteristics of children with HSP complicated with infection.Results : The total number of cases was 145.According to the detection of pathogens,the children with positive pathogens were in the infection group(73 cases),while the children with negative pathogens were in the non-infection group(72 cases).The infection group was divided into group A(9 cases of EB virus infection),group B(1 case of cytomegalovirus infection),group C(48 cases of Mycoplasma pneumoniae infection),group D(4 cases of Coxsackie B virus infection),and group E(11 cases of combined infection with two or more aforementioned pathogens).Among 145 cases,there were 77 males and 68 females,the ratio of males to females was 1.13:1;the average age was 7.94 years old,ranging from 2.58 to 16.5 years old.In the infection group,47 cases(64.38%)presented with skin rash as the first manifestation.The other manifestations were skin rash with joint symptoms in 8 cases(10.96%),digestive tract symptoms in 7 cases(9.59%),joint symptoms in 6 cases(8.22%)and skin rash with digestive tract symptoms in 5 cases(6.85%).In the non-infectious group,47 cases(65.28%)presented with skin rash as the first manifestation,13 cases(18.05%)with digestive tract symptoms,6cases(8.33%)with skin rash combined with joint symptoms,3 cases(4.17%)with joint symptoms,and 3 cases(4.17%)with skin rash combined with digestive tract symptoms.There was no significant difference in the first appearance between the two groups(P > 0.05).In the cases of infection,the proportion of rash as the first manifestation was the highest inthe different pathogenic infection groups,and there was no significant difference in the first symptoms among the groups(P > 0.05).There were61 cases(83.56%)of renal damage in the infected group,and 56 cases(77.78%)in the non-infected group,there was no significant difference(P >0.05).There was no significant difference in the proportion of children with renal impairment among group A(88.89%),group B(100%),group C(83.33%),group D(100%)and group E(72.73%)in infection group(P >0.05).There was no significant difference in the proportion of children with recurrent rash,digestive tract symptoms and joint symptoms between group A,group B,group C,group D and group E(P > 0.05).There were no significant differences in white cell count,platelet count,Ig E level,albumin level and globulin level among different pathogenic infection groups.However,at the level of Ig A,there were significant differences between group A(7.75 + 2.71)and group D(14.91 + 7.05)(P = 0.019),group C(9.70 + 4.53)and group D(14.91 + 7.05)(P = 0.039).Conclusions:1.Infection is the common cause of Henoch-Schonlein purpura in children,and the most common pathogen is Mycoplasma pneumoniae infection.2.Infection is not closely related to the first appearance of Henoch-Schonlein purpura in children.Infection has no obvious influence on clinical manifestations,and is not closely related to the recurrence of rashes.3.Kidney damage in children with Henoch-Schonlein purpura is not related to co-infection,and is not relatedto the types of pathogens of infection.Infection is not yet proven to be the cause of renal damage in children with Henoch-Schonlein purpura. |
