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- Title
Adult Henoch-Schönlein purpura: Clinical and histopathological predictors of systemic disease and profound renal disease.
- Authors
Cao, Ruoxi; Lau, Sandra; Tan, Virlynn; Tey, Hong Liang
- Abstract
<bold>Background: </bold>A major challenge in the management of adult Henoch-Schönlein purpura is the difficulty in assessing the risk of systemic involvement. There is currently a paucity of data in this area.<bold>Aims: </bold>This study sought to determine specific clinical and histopathological features associated with systemic involvement in adult Henoch-Schönlein purpura.<bold>Methods: </bold>We reviewed the records of 99 adult Henoch-Schönlein purpura patients who presented at the National Skin Centre, Singapore, between January 2008 and May 2015.<bold>Results: </bold>Renal involvement was found in 56 (56.6%) patients, joint involvement in 21 (21.2%) and gastrointestinal involvement in 13 (13.1%). Age > 30 years was an independent predictor of renal involvement with an adjusted odds ratio of 2.97 (95% confidence interval, 1.08-8.16; P = 0.04). Risk factors for significant renal involvement necessitating nephrology referral were further evaluated: the odds were approximately 60% higher for every 10-year increase in age (95% confidence interval, 1.02-2.57; P = 0.04) and patients with cutaneous bullae and/or necrosis had an almost six times higher risk (95% confidence interval, 1.43-25.00; P = 0.01).<bold>Limitations: </bold>This study was limited by its retrospective design. We also lacked long-term data to examine how clinical and histopathological characteristics correlated with long-term disease outcomes.<bold>Conclusions: </bold>Adult Henoch-Schönlein purpura patients older than 30 years have a threefold increased risk of renal involvement. The risk of profound renal disease necessitating nephrology referral rose significantly with age and the presence of cutaneous bullae and/or necrosis.
- Subjects
KIDNEY disease diagnosis; KIDNEY diseases; PREDICTIVE tests; RETROSPECTIVE studies; SCHOENLEIN-Henoch purpura; DIAGNOSIS
- Publication
Indian Journal of Dermatology, Venereology & Leprology, 2017, Vol 83, Issue 5, p577
- ISSN
0378-6323
- Publication type
journal article
- DOI
10.4103/ijdvl.IJDVL_571_16