Henoch-Schonlein Purpura in Thai Children: A Report from Single Center
Pimprae Pengpis MD*, Sukrawan Intrakao MD*, Sookkasem Khositseth MD*
Affiliation : * Department of Pediatrics, Faculty of Medicine, Thammasat University, Klongluang, Pathumthani, Thailand
Henoch Schonlein Purpura (HSP) is the most common vasculitis in childhood. It is a self-limited disease. Recurrent HSP is not uncommon. Colchicine, an anti-inflammatory drug, has been used in prolonged HSP in only a few patients with good response. The present study described pediatric HSP patients in a single center, Thailand. To determine the epidemiology, clinical manifestations, treatments, and outcomes of HSP patients, the authors retrospectively studied 26 patients (age <15 years) diagnosed with HSP at Thammasat University Hospital, from January 01, 2004 through December 31, 2010. The mean age was 7.2 + 3.8 years; median (range) follow-up was 2 (0.5-39) months. Fifteen (57.7%) patients were female. Clinical manifestations were skin (100%), joint (69.2%), gastrointestinal symptoms (50%) and renal involvement (19.2%). Symptoms lasted within 8 weeks in 21(80%) patients. Recurrences identified in 5 (19%) patients with a mean of 4.8 + 2.4 times. The clinical outcome was excellent without major complication. Colchicine induced remission of severe and recurrent petechiae in one patient who developed methemoglobinemia after dapsone therapy. Colchicine may be an effective drug for prolonged HSP without renal involvement. The controlled studies to establish benefit effect and optimal regimen of colchicine in HSP is required.
Keywords : Henoch-Schonlein purpura, Recalcitrant Henoch- Schonlein purpura, Recurrent Henoch-Schonlein purpura, Colchicine, Asian Children
