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Renal involvement in Henoch-Schönlein purpura: a multivariate analysis of initial prognostic factors

de Almeida, José Luiz J ; Campos, Lúcia Maria A ; Paim, Luciana B ; Leone, Claudio ; Koch, Vera Hermínia K ; Silva, Clovis Artur A

Jornal de pediatria, 2007-05, Vol.83 (3), p.259-266 [Periódico revisado por pares]

Brazil

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  • Título:
    Renal involvement in Henoch-Schönlein purpura: a multivariate analysis of initial prognostic factors
  • Autor: de Almeida, José Luiz J ; Campos, Lúcia Maria A ; Paim, Luciana B ; Leone, Claudio ; Koch, Vera Hermínia K ; Silva, Clovis Artur A
  • Assuntos: Abdominal Pain - etiology ; Adolescent ; Analysis of Variance ; Child ; Female ; Humans ; Kidney Diseases - drug therapy ; Kidney Diseases - etiology ; Male ; Nephritis - etiology ; Odds Ratio ; Prognosis ; Purpura, Schoenlein-Henoch - complications ; Purpura, Schoenlein-Henoch - drug therapy ; Retrospective Studies ; Risk Factors ; Severity of Illness Index
  • É parte de: Jornal de pediatria, 2007-05, Vol.83 (3), p.259-266
  • Notas: ObjectType-Article-1
    SourceType-Scholarly Journals-1
    ObjectType-Feature-2
    content type line 23
  • Descrição: To identify initial predictive factors of renal involvement in children and adolescents with Henoch-Schönlein purpura. We reviewed the medical records of 142 patients admitted to our University Hospital over a 21-year period with a diagnosis of Henoch-Schönlein purpura. The initial predictive factors assessed, observed during the first 3 months, included: demographic data, clinical manifestations (persistent palpable purpura, arthritis, abdominal pain, severe abdominal pain, gastrointestinal bleeding, orchitis, central nervous system involvement and pulmonary hemorrhage), laboratory tests (serum IgA levels) and treatment given (corticosteroids, intravenous immunoglobulin and immunosuppressive drugs). Patients were divided into two groups (presence or absence of nephritis) and assessed by univariate and multivariate analysis. Evidence of nephritis was detected in 70 patients (49.3%). The univariate analysis revealed that severe abdominal pain (p=0.0049; OR=1.6; 95%CI 1.18-2.21), gastrointestinal bleeding (p=0.004; OR=1.6; 95%CI 1.10-2.26) and corticosteroid use (p=0.0012; OR=1.7; 95%CI 1.28-2.40) were all associated with increased incidence of renal involvement. In the multivariate analysis, logistic regression demonstrated that the only independent variable that predicted nephritis was intense abdominal pain (p<0.012; OR=2.593; 95%CI 1.234-5.452). Severe abdominal pain was a significant predictor of nephritis in Henoch-Schönlein purpura. Consequently, pediatric patients exhibiting this clinical manifestation should be rigorously monitored, due to the increased risk of renal involvement.
  • Editor: Brazil
  • Idioma: Inglês
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  • Realização: ABCD-USP USP   Logos de Redes Sociais: Freepik

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