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Schönlein-Henoch Purpura in Children and AdultsDiagnosis, Pathophysiology and Management

 

作者: Guy Rostoker,  

 

期刊: BioDrugs  (ADIS Available online 2001)
卷期: Volume 15, issue 2  

页码: 99-138

 

ISSN:1173-8804

 

年代: 2001

 

出版商: ADIS

 

关键词: Adolescents;Analgesics, therapeutic use;Anti inflammatories, therapeutic use;Children;Corticosteroids, therapeutic use;Dapsone, therapeutic use;Henoch Schoenlein purpura, general;Immunoglobulins, therapeutic use;Immunosuppressants, therapeutic use;Nonster

 

数据来源: ADIS

 

摘要:

Schönlein-Henoch syndrome is a form of systemic small-vessel vasculitis, characterised by vascular and/or mesangial immunoglobulin A1 deposits. The main clinical manifestations are vascular purpura, predominating on the lower limbs, and articular, gastrointestinal and renal symptoms. Pulmonary, cardiac, genital and neurological symptoms have also be observed. The syndrome usually affects children, whereas it is rare in adults.The frequency of renal involvement varies between individual studies (from 20 to 100%). Renal manifestations are usually mild and transient, although chronic nephropathies may occur. Overall, an estimated 2% of children with Schönlein-Henoch purpura progress to renal failure and up to 20% of children with nephritis treated in specialised centres require haemodialysis. The renal prognosis appears to be worse in adults. Aetiological investigations are required, as a triggering factor is found in approximately half the patients (e.g. viral, bacterial and parasitic infections, drugs, toxins, systemic diseases and cancer).Dapsone has beneficial effects on cutaneous, gastrointestinal and articular manifestations in adults, especially those with chronic forms. Corticosteroids may be useful for refractory abdominal pain. Methylprednisolone pulse therapy, immunosuppressive drugs (e.g. cyclophosphamide and azathioprine), plasma exchange and polyclonal immunoglobulin therapy are beneficial in very rare life-threatening forms of the disease and in rare instances where renal function is compromised.

 

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