Adult Henoch-Schönlein Purpura: Comprehensive Assessment of Demographic, Clinical, and Histopathological Features as Predictors for Systemic Involvement
Background: Henoch-Schönlein purpura (HSP) is a small-vessel IgA-predominant vasculitis. A major challenge in managing adult HSP is the difficulty assessing the risk of systemic involvement. There is currently a paucity of data in this area. Objective: The objective of this study was to determine de...
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Veröffentlicht in: | Dermatology (Basel) 2023-08, Vol.239 (4), p.609-615 |
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creator | Hammad, Helwe Krausz, Judit Barcan, Moran Fisher, Shani Edison, Natasha Ziv, Michael |
description | Background: Henoch-Schönlein purpura (HSP) is a small-vessel IgA-predominant vasculitis. A major challenge in managing adult HSP is the difficulty assessing the risk of systemic involvement. There is currently a paucity of data in this area. Objective: The objective of this study was to determine demographic, clinical, and histopathological features associated with systemic involvement in adult HSP. Methods: In this retrospective study, we reviewed demographical features and clinical and pathology data of 112 adult HSP patients seen at Emek Medical Center between January 2008 and December 2020. Results: Of these patients, 41 (36.6%) had renal involvement, 24 (21.4%) had gastrointestinal tract involvement, and 31 (27.7%) had joint involvement. Age >30 years (p = 0.006) at diagnosis was an independent predictor of renal involvement. Platelet count ( |
doi_str_mv | 10.1159/000530820 |
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A major challenge in managing adult HSP is the difficulty assessing the risk of systemic involvement. There is currently a paucity of data in this area. Objective: The objective of this study was to determine demographic, clinical, and histopathological features associated with systemic involvement in adult HSP. Methods: In this retrospective study, we reviewed demographical features and clinical and pathology data of 112 adult HSP patients seen at Emek Medical Center between January 2008 and December 2020. Results: Of these patients, 41 (36.6%) had renal involvement, 24 (21.4%) had gastrointestinal tract involvement, and 31 (27.7%) had joint involvement. Age >30 years (p = 0.006) at diagnosis was an independent predictor of renal involvement. Platelet count (<150 K/µL) (p = 0.020) and apoptosis of keratinocytes on skin biopsy (p = 0.031) were also associated with renal involvement. History of autoimmune disease (p = 0.001), positive c-antineutrophil cytoplasmic antibody (p = 0.018), positive rheumatoid factor (p = 0.029), and elevated erythrocyte sedimentation rate (p = 0.04) were associated with joint involvement. Female sex (p = 0.003), Arab race (p = 0.036), and positive pANCA (p = 0.011) were associated with gastrointestinal tract involvement. Limitations: This study is retrospective. Conclusion: These findings may serve as a guide to stratify risk in adult HSP patients so that those at higher risk can be monitored more closely.</description><identifier>ISSN: 1018-8665</identifier><identifier>EISSN: 1421-9832</identifier><identifier>DOI: 10.1159/000530820</identifier><identifier>PMID: 37231802</identifier><language>eng</language><publisher>Basel, Switzerland</publisher><subject>Research Article</subject><ispartof>Dermatology (Basel), 2023-08, Vol.239 (4), p.609-615</ispartof><rights>2023 S. Karger AG, Basel</rights><rights>2023 S. Karger AG, Basel.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c334t-934c396cf21f07982770ee33ad0c33533517a2f668b73515fdecd65cd015ab353</citedby><cites>FETCH-LOGICAL-c334t-934c396cf21f07982770ee33ad0c33533517a2f668b73515fdecd65cd015ab353</cites><orcidid>0000-0001-8071-289X</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,2423,27905,27906</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37231802$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hammad, Helwe</creatorcontrib><creatorcontrib>Krausz, Judit</creatorcontrib><creatorcontrib>Barcan, Moran</creatorcontrib><creatorcontrib>Fisher, Shani</creatorcontrib><creatorcontrib>Edison, Natasha</creatorcontrib><creatorcontrib>Ziv, Michael</creatorcontrib><title>Adult Henoch-Schönlein Purpura: Comprehensive Assessment of Demographic, Clinical, and Histopathological Features as Predictors for Systemic Involvement</title><title>Dermatology (Basel)</title><addtitle>Dermatology</addtitle><description>Background: Henoch-Schönlein purpura (HSP) is a small-vessel IgA-predominant vasculitis. A major challenge in managing adult HSP is the difficulty assessing the risk of systemic involvement. There is currently a paucity of data in this area. Objective: The objective of this study was to determine demographic, clinical, and histopathological features associated with systemic involvement in adult HSP. Methods: In this retrospective study, we reviewed demographical features and clinical and pathology data of 112 adult HSP patients seen at Emek Medical Center between January 2008 and December 2020. Results: Of these patients, 41 (36.6%) had renal involvement, 24 (21.4%) had gastrointestinal tract involvement, and 31 (27.7%) had joint involvement. Age >30 years (p = 0.006) at diagnosis was an independent predictor of renal involvement. Platelet count (<150 K/µL) (p = 0.020) and apoptosis of keratinocytes on skin biopsy (p = 0.031) were also associated with renal involvement. History of autoimmune disease (p = 0.001), positive c-antineutrophil cytoplasmic antibody (p = 0.018), positive rheumatoid factor (p = 0.029), and elevated erythrocyte sedimentation rate (p = 0.04) were associated with joint involvement. Female sex (p = 0.003), Arab race (p = 0.036), and positive pANCA (p = 0.011) were associated with gastrointestinal tract involvement. Limitations: This study is retrospective. Conclusion: These findings may serve as a guide to stratify risk in adult HSP patients so that those at higher risk can be monitored more closely.</description><subject>Research Article</subject><issn>1018-8665</issn><issn>1421-9832</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><recordid>eNpt0d1qFDEUB_AgFlurF96LBLyx0NF87Hx5t2ytW2ixWL0essnJTjSTjElmoY_SF_EF-mJm2XWvCgdyCD_-B85B6A0lHykt20-EkJKThpFn6ITOGC3ahrPnuSe0KZqqKo_Ryxh_Zcaaun2BjnnNOG0IO0EPczXZhJfgvOyLO9k__nUWjMO3UxinID7jhR_GAD24aDaA5zFCjAO4hL3GFzD4dRBjb-Q5XljjjBT2HAun8NLE5EeRem_9evuNL0GkKUDEIuLbAMrI5EPE2gd8dx8TDEbiK7fxdgPb_FfoSAsb4fX-PUU_L7_8WCyL629frxbz60JyPktFy2eSt5XUjGpStw2rawLAuVAkgzIXrQXTVdWs6tyXWoFUVSkVoaVYZXCKPuxyx-D_TBBTN5gowVrhwE-xY3mvhLVtWWV6tqMy-BgD6G4MZhDhvqOk216iO1wi23f72Gk1gDrI_6vP4P0O_BZhDeEALr7f7CK6Uems3j6p9lP-AY3Cmt4</recordid><startdate>20230801</startdate><enddate>20230801</enddate><creator>Hammad, Helwe</creator><creator>Krausz, Judit</creator><creator>Barcan, Moran</creator><creator>Fisher, Shani</creator><creator>Edison, Natasha</creator><creator>Ziv, Michael</creator><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8071-289X</orcidid></search><sort><creationdate>20230801</creationdate><title>Adult Henoch-Schönlein Purpura: Comprehensive Assessment of Demographic, Clinical, and Histopathological Features as Predictors for Systemic Involvement</title><author>Hammad, Helwe ; Krausz, Judit ; Barcan, Moran ; Fisher, Shani ; Edison, Natasha ; Ziv, Michael</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c334t-934c396cf21f07982770ee33ad0c33533517a2f668b73515fdecd65cd015ab353</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2023</creationdate><topic>Research Article</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hammad, Helwe</creatorcontrib><creatorcontrib>Krausz, Judit</creatorcontrib><creatorcontrib>Barcan, Moran</creatorcontrib><creatorcontrib>Fisher, Shani</creatorcontrib><creatorcontrib>Edison, Natasha</creatorcontrib><creatorcontrib>Ziv, Michael</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Dermatology (Basel)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hammad, Helwe</au><au>Krausz, Judit</au><au>Barcan, Moran</au><au>Fisher, Shani</au><au>Edison, Natasha</au><au>Ziv, Michael</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adult Henoch-Schönlein Purpura: Comprehensive Assessment of Demographic, Clinical, and Histopathological Features as Predictors for Systemic Involvement</atitle><jtitle>Dermatology (Basel)</jtitle><addtitle>Dermatology</addtitle><date>2023-08-01</date><risdate>2023</risdate><volume>239</volume><issue>4</issue><spage>609</spage><epage>615</epage><pages>609-615</pages><issn>1018-8665</issn><eissn>1421-9832</eissn><abstract>Background: Henoch-Schönlein purpura (HSP) is a small-vessel IgA-predominant vasculitis. A major challenge in managing adult HSP is the difficulty assessing the risk of systemic involvement. There is currently a paucity of data in this area. Objective: The objective of this study was to determine demographic, clinical, and histopathological features associated with systemic involvement in adult HSP. Methods: In this retrospective study, we reviewed demographical features and clinical and pathology data of 112 adult HSP patients seen at Emek Medical Center between January 2008 and December 2020. Results: Of these patients, 41 (36.6%) had renal involvement, 24 (21.4%) had gastrointestinal tract involvement, and 31 (27.7%) had joint involvement. Age >30 years (p = 0.006) at diagnosis was an independent predictor of renal involvement. Platelet count (<150 K/µL) (p = 0.020) and apoptosis of keratinocytes on skin biopsy (p = 0.031) were also associated with renal involvement. History of autoimmune disease (p = 0.001), positive c-antineutrophil cytoplasmic antibody (p = 0.018), positive rheumatoid factor (p = 0.029), and elevated erythrocyte sedimentation rate (p = 0.04) were associated with joint involvement. Female sex (p = 0.003), Arab race (p = 0.036), and positive pANCA (p = 0.011) were associated with gastrointestinal tract involvement. Limitations: This study is retrospective. Conclusion: These findings may serve as a guide to stratify risk in adult HSP patients so that those at higher risk can be monitored more closely.</abstract><cop>Basel, Switzerland</cop><pmid>37231802</pmid><doi>10.1159/000530820</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-8071-289X</orcidid></addata></record> |
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title | Adult Henoch-Schönlein Purpura: Comprehensive Assessment of Demographic, Clinical, and Histopathological Features as Predictors for Systemic Involvement |
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