AB1166 Henoch-schoenlein purpura: Clinical study of 340 patients

Background Most Henoch-Schonlein Purpura (HSP) studies came from selected series and used different classification criteria Objectives Our aim was to assess the epidemiological, clinical features, treatment and prognosis in an unselected and well-defined seriesof HSP. Methods Retrospective study of a wide series of patients from two hospitals diagnosed as having HSP. Patients with vasculitis secondary to connective-tissue diseases, malignancies, severe infections, primary systemic necrotizing vasculitides, and those with other well-defined clinical conditions such as hipersensitivity vasculitis and essential myxed cryoglobulinemia were excluded from this analysis. Patients were classified as having HSP according to the criteria proposed by Michel et al [1]. Results According to the above mentioned criteria 340 patients (194 men/146 women), with a mean ±SD age of 18.7±22.6 years (range; 1 to 87) were classified as having HSP. Most of the patients (256) were young people (subset established if the disease occurred in individuals younger than 20 years) (6.9±3.1 years) and 84 were adults (54.6±17.5 years). Precipitating events were found in 41.2% of patients. A history of drug intake before the onset of vasculitis was found in 19.7% and a previous upper respiratory tract infection in 35.3%. At disease onset, the most common manifestations were skin lesions (62%), abdominal pain (19.5%), joint symptoms (11%) and fever (8.8%). When the HSP disease was diagnosed the most frequent manifestations were cutaneous (99.7%), gastrointestinal (65.6%), joint (63%), and renal involvement (41.5%). The main laboratory data were elevated ESR (31.9%), leukocytosis (32.6%), anemia (8.5%), positive rheumatoid factor (6 of 139 cases tested), positive ANA (17 of 148), C3 and/or C4 decreased (14 of 285), negative cryoglobulins (60 of 78) and negative ANCAs (35 of 35). The more frequent treatments were: NSADs (11.2%), corticosteroids (33.5%), and cytotoxic agents (5.3%) (azathioprine in 6 cases, cyclophosphamide in 6 and methotrexate in 1). After a mean follow-up of 32.9±51.2 (median, 12) months, relapses were observed in 28.5% of patients, complete recovery in 84.1%, persisted mild renal insufficiency in 4 cases and mild hematuria in 26 cases. Conclusions HSP as defined by the criteria proposed by Michel et al, represents a relatively benign syndrome that affects predominantly to young population. References Michel BA, Hunder GG, Bloch DA, Calabrese LH. Hypersensitivity vasculitis