Modern views at the morbidity and course of Henoch-Schönlein purpura in children: a literature review
DOI:
https://doi.org/10.14739/2310-1210.2020.6.218475Keywords:
children, hemorrhagic vasculitis, clinical pathologyAbstract
The article presents data on the prevalence, etiology, pathogenesis and clinical features of hemorrhagic vasculitis in children, based on the modern scientific literature.
The aim of the study was to establish frequency and features of Henoch-Schönlein purpura course in children over the past decade.
Materials and methods. Scientific and metric systems Google Scholar, PubMed, CyberLeninka, Cochrane database for the period of 2015–2019 were searched, using the keywords “hemorrhagic vasculitis”, “IgA-аssociated vasculitis”, “acute respiratory infections”, “bacterial infections”, “etiology and pathogenesis”, “clinics”. The frequency of the disease in the population was also analyzed, according to the data of the initial presentation at the inpatient and polyclinic of the Ivano-Frankivsk Regional Children's Clinical Hospital of the Ivano-Frankivsk Regional Council, for the period between 2015 and 2019 respectively.
Conclusion. It was established that hemorrhagic vasculitis is the most common in childhood, and is diagnosed approximately in 50 % of cases. The disease is triggered mostly by the genetic, infectious and non-identified factors. The authours have distinguished such pathogenic links as glycosylation disorders of immunoglobulin A, the accumulation of circulating immune complexes, resulting in specific inflammation and blood clotting disorders with subsequent development of thrombosis. There are following clinical findings for hemorrhagic vasculitis: palpable purpura, diffuse abdominal pain, accumulation of IgA (confirmed by biopsy of any organ); arthritis or arthralgia; kidney damage (hematuria and/or proteinuria). These data need to be clarified, and further clinical, cohort, and prospective studies should be conducted.
References
Artamonov, R. G., Paunova, S. S., Glazunova, L. V., Polyakov, M. V., Kirillina, S. A., Busova, E. S., Gammel, E. N., & Timina, Ya. D. (2015). Gemorragicheskii vaskulit, oslozhnennyi tonko-tolstokishechnoi invaginatsiei, u rebenka 5 let [Henoch’s disease complicated by intestinal intussusception in a 5-year-old child]. Rossiyskiy Vestnik Perinatologii i Pediatrii, 60(2), 92-94. [in Russian].
Boiarchuk, O. R., & Sahal, I. R. (2017). Hemorahichnyi (IgA-) vaskulit u ditei: suchasnyi pohliad na problemu [Henoch – Schonlein purpura (IgA-vasculitis) in children: modern approach to the problem]. Klinichna imunolohiia. Alerholohiia. Infektolohiia, (7-8), 25-29. [in Ukrainian].
Marushko, T. V., Kornieva, V. V., & Kulchytska, E. B. (2019). Hemorahichnyi vaskulit u ditei: osoblyvosti diahnostyky ta likuvannia na suchasnomu etapi [Anaphylactoid purpura in children: modern concepts of the diagnosis and treatment]. Dytiachyi likar, (1), 16-22. [in Ukrainian].
Odynets, Yu. V., & Yavorovych, M. V. (2015). Endotelialna dysfunktsiia yak diahnostychno-prohnostychnyi kryterii perebihu hemorahichnoho vaskulitu v ditei [Endothelial dysfunction as a diagnostic and prognosis criterion of hemorrhagic vasculitis course in children]. Aktualni pytannia pediatrii, akusherstva ta hinekolohii, (1), 61-63. https://doi.org/10.11603/24116-4944.2015.1.4673 [in Ukrainian].
Odynets, Yu. V., & Yavorovych, M. V. (2016). Ultrazvukovi ta biokhimichni pokaznyky dysfunktsii endoteliiu pry hemorahichnomu vaskuliti u ditei [Ultrasound and biochemical indices of endothelial dysfunction at hemorrhagic vasculitis in children]. Zdorov'e rebenka, (2), 16-20. https://doi.org/10.22141/2224-0551.2.70.2016.73792 [in Ukrainian].
Oshlyanska, E. A., Oknotnikova, E. N., Slepova, L. F., Baevska, I. O., Marchuk, O. I., Vinnichuk, L. L., Krat, V. V., & Artsimovich, A. H. (2017). Systemnyi nekrotyzuiuchyi vaskulit u ditei [Systemic necrotizing vasculitis in children]. Klinichna imunolohiia. Alerholohiia. Infektolohiia, (2), 79-86. [in Ukrainian].
Piletskii, A. M., Snigir, N. V., Rudichenko, V. M., Kryvets, V. O., & Maslij, M. G. (2019). Skladnyi dyferentsiinyi diahnoz hemorahichnoho vaskulitu u praktytsi likaria zahalnoi praktyky-simeinoi medytsyny: vlasni klinichni sposterezhennia ta dani literatury [Difficult differential diagnosis of hemorrhagic vasculitis in the practice of general physician-family practitioner: own clinical observations and literature data]. Semeinaya meditsina, (2), 49-53. [in Ukrainian].
Protsenko, G. A., & Kachur, V. V. (2016). Izolovanyi shkirnyi vaskulit: problema na mezhi spetsialnoste [Isolated cutaneous vasculitis: problems at the border of specialties]. Ukrainskyi revmatolohichnyi zhurnal, (3), 59-65 [in Ukrainian].
Chernyshova, O. E., Gerasymenko, V. V., Yegudina, E. D., Syniachenko, O. V., & Ermolaeva, M. V. (2016). Evolyutsiya yuvenil'noi purpury Shenlaina-Genokha [The evolution of juvenile Schönlein-Henoch purpura]. Zdorov'e rebenka, (7), 85-89. https://doi.org/10.22141/2224-0551.7.75.2016.86730 [in Russian].
Iaremenko, O. B., & Petelytska, L. B. (2014). Dermatolohichni proiavy systemnykh vaskulitiv [Dermatological manifestations of systemic vasculitis]. Praktykuiuchyi likar, (3), 60-66. [in Ukrainian].
Alharthi, A. A. (2016). Henoch-Schonlein Purpura in Saudi Arabia: A Retrospective Study of 27 Children in Taif Region. Current Pediatric Research, 20(1&2), 126-131. https://www.alliedacademies.org/articles/henochschonlein-purpura-in-saudi-arabia-a-retrospective-study-of-27-children-in-taif-region.html
Aleyd, E., Heineke, M. H., & van Egmond, M. (2015). The era of the immunoglobulin A Fc receptor FcαRI; its function and potential as target in disease. Immunological Reviews, 268(1), 123-138. https://doi.org/10.1111/imr.12337
Bukhari, E. M., Al-Sofyani, K. A., & Muzaffer, M. A. (2015). Spectrum of Henoch-Schonlein Purpura in Children: A Single-Center Experience from Western Provence of Saudi Arabia. Open Journal of Rheumatology and Autoimmune Diseases, 5(1), 17-22. https://doi.org/10.4236/ojra.2015.51004
Calvo-Río, V., Hernández, J. L., Ortiz-Sanjuán, F., Loricera, J., Palmou-Fontana, N., González-Vela, M. C., González-Lamuño, D., González-López, M. A., Armesto, S., Blanco, R., & González-Gay, M. A. (2016). Relapses in patients with Henoch-Schönlein purpura: Analysis of 417 patients from a single center. Medicine, 95(28), Article e4217. https://doi.org/10.1097/MD.0000000000004217
Davin, J. C., & Coppo, R. (2014). Henoch-Schönlein purpura nephritis in children. Nature Reviews Nephrology, 10(10), 563-573. https://doi.org/10.1038/nrneph.2014.126
Delbet, J. D., Hogan, J., Aoun, B., Stoica, I., Salomon, R., Decramer, S., Brocheriou, I., Deschênes, G., & Ulinski, T. (2017). Clinical outcomes in children with Henoch-Schönlein purpura nephritis without crescents. Pediatric Nephrology, 32(7), 1193-1199. https://doi.org/10.1007/s00467-017-3604-9
Hahn, D., Hodson, E. M., Willis, N. S., & Craig, J. C. (2015). Interventions for preventing and treating kidney disease in Henoch-Schönlein Purpura (HSP). Cochrane Database of Systematic Reviews, (8), Article CD005128. https://doi.org/10.1002/14651858.CD005128.pub3
Yang, H. R. (2018). What We Know about Henoch-Schönlein Purpura in Children up to Date? Journal of Korean Medical Science, 33(25), Article e199. https://doi.org/10.3346/jkms.2018.33.e199
Hwang, H. H., Lim, I. S., Choi, B. S., & Yi, D. Y. (2018). Analysis of seasonal tendencies in pediatric Henoch-Schönlein purpura and comparison with outbreak of infectious diseases. Medicine, 97(36), Article e12217. https://doi.org/10.1097/MD.0000000000012217
Ghrahani, R., Ledika, M. A., Sapartini, G., & Setiabudiawan, B. (2014). Age of onset as a risk factor of renal involvement in Henoch-Schönlein purpura. Asia Pacific Allergy, 4(1), 42-47. https://doi.org/10.5415/apallergy.2014.4.1.42
Wang, J. J., Xu, Y., Liu, F. F., Wu, Y., Samadli, S., Wu, Y. F., Luo, H. H., Zhang, D. D., & Hu, P. (2020). Association of the infectious triggers with childhood Henoch-Schonlein purpura in Anhui province, China. Journal of Infection and Public Health, 13(1), 110-117. https://doi.org/10.1016/j.jiph.2019.07.004
Kang, Y., Park, J. S., Ha, Y. J., Kang, M. I., Park, H. J., Lee, S. W., Lee, S. K., & Park, Y. B. (2014). Differences in clinical manifestations and outcomes between adult and child patients with Henoch-Schönlein purpura. Journal of Korean Medical Science, 29(2), 198-203. https://doi.org/10.3346/jkms.2014.29.2.198
Lee, Y. H., Kim, Y. B., Koo, J. W., & Chung, J. Y. (2016). Henoch-Schonlein Purpura in Children Hospitalized at a Tertiary Hospital during 2004-2015 in Korea: Epidemiology and Clinical Management. Pediatric Gastroenterology, Hepatology & Nutrition, 19(3), 175-185. https://doi.org/10.5223/pghn.2016.19.3.175
Lei, W. T., Tsai, P. L., Chu, S. H., Kao, Y. H., Lin, C. Y., Fang, L. C., Shyur, S. D., Lin, Y. W., & Wu, S. I. (2018). Incidence and risk factors for recurrent Henoch-Schönlein purpura in children from a 16-year nationwide database. Pediatric Rheumatology, 16(1), Article 25. https://doi.org/10.1186/s12969-018-0247-8
López-Mejías, R., Genre, F., Pérez, B. S., Castañeda, S., Ortego-Centeno, N., Llorca, J., Ubilla, B., Remuzgo-Martínez, S., Mijares, V., Pina, T., Calvo-Río, V., Márquez, A., Miranda-Filloy, J. A., Parejo, A. N., Conde-Jaldón, M., Ortiz-Fernández, L., Argila, D., Aragües, M., Rubio, E., Luque, M. L., … González-Gay, M. A. (2015). Association of HLA-B*41:02 with Henoch-Schönlein Purpura (IgA Vasculitis) in Spanish individuals irrespective of the HLA-DRB1 status. Arthritis Research & Therapy, 17(1), Article 102. https://doi.org/10.1186/s13075-015-0622-5
Jokar, M., & Mirfeizi, Z. (2015). Epidemiology of Vasculitides in Khorasan Province, Iran. Iranian Journal of Medical Sciences, 40(4), 362-366.
Novak, J., Rizk, D., Takahashi, K., Zhang, X., Bian, Q., Ueda, H., Ueda, Y., Reily, C., Lai, L. Y., Hao, C., Novak, L., Huang, Z. Q., Renfrow, M. B., Suzuki, H., & Julian, B. A. (2015). New Insights into the Pathogenesis of IgA Nephropathy. Kidney Diseases, 1(1), 8-18. https://doi.org/10.1159/000382134
Oni, L., & Sampath, S. (2019). Childhood IgA Vasculitis (Henoch Schonlein Purpura)-Advances and Knowledge Gaps. Frontiers in Pediatrics, 7, Article 257. https://doi.org/10.3389/fped.2019.00257
Özer, S., Kasap, T., Yılmaz, R., Sönmezgöz, E., & Ünüvar, Ş. (2015). Henoch-Schönlein Purpura in Children: Retrospective evaluation of 53 cases. Journal of Contemporary Medicine, 5, 152-156.
Park, C. W., Lim, I. S., Yun, S. W., Chae, S. A., Lee, N. M., & Yi, D. Y. (2016). Henoch-Schonlein purpura without typical lesions, presenting with gastrointestinal manifestations and kidney involvement following influenza - A case report. JPMA. The Journal of the Pakistan Medical Association, 66(10), 1339-1342.
Piram, M., Maldini, C., Biscardi, S., De Suremain, N., Orzechowski, C., Georget, E., Regnard, D., Koné-Paut, I., & Mahr, A. (2017). Incidence of IgA vasculitis in children estimated by four-source capture-recapture analysis: a population-based study. Rheumatology, 56(8), 1358-1366. https://doi.org/10.1093/rheumatology/kex158
Farhadian, J. A., Castilla, C., Shvartsbeyn, M., Meehan, S. A., Neimann, A., & Pomeranz, M. K. (2015). IgA vasculitis (Henoch-Schönlein purpura). Dermatology Online Journal, 21(12), Article 13030/qt72p3m3q2.
Shim, J. O., Han, K., Park, S., Kim, G. H., Ko, J. S., & Chung, J. Y. (2018). Ten-year Nationwide Population-based Survey on the Characteristics of Children with Henoch-Schӧnlein Purpura in Korea. Journal of Korean Medical Science, 33(25), Article e174. https://doi.org/10.3346/jkms.2018.33.e174
Su, H. W., Chen, C. Y., & Chiou, Y. H. (2018). Hemorrhagic bullous lesions in Henoch-Schönlein purpura: a case report and review of the literature. BMC Pediatrics, 18(1), Article 157. https://doi.org/10.1186/s12887-018-1117-8
Wei, C. C., Lin, C. L., Shen, T. C., Li, T. C., & Chen, A. C. (2016). Atopic Dermatitis and Association of Risk for Henoch-Schönlein Purpura (IgA Vasculitis) and Renal Involvement Among Children: Results From a Population-Based Cohort Study in Taiwan. Medicine, 95(3), Article e2586. https://doi.org/10.1097/MD.0000000000002586
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